Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
Browse
3 results
Search Results
Item Restricted Hospitalized Patients’ Perception of Medication Safety Engagement in the Kingdom of Saudi Arabia(The Catholic University of America, 2025) Alenizi, Awatif; E. Johnson, Joyce; Asano, Reiko; C. McMullen, PatriciaIn the Kingdom of Saudi Arabia (KSA), medication errors (MEs) during different stages of the medication use process are a significant concern, especially in inpatient hospital units. MEs place hospitalized patients at risk for adverse outcomes. Patient engagement in their medication safety (MS) behaviors may present an extra defense against inadvertent MEs caused by healthcare providers (HCPs). However, little is known about how hospitalized patients choose to engage in MS activities that may reduce or prevent MEs. This descriptive phenomenological study aimed to explore hospitalized patients’ personal perceptions of engaging in MS behaviors to reduce or prevent MEs. Using purposive sampling, the principal investigator interviewed 22 patients hospitalized in medical and surgical units in three KSA hospitals using individual audio-recorded interviews. Using thematic analysis, themes, sub-themes, and categories were identified in relationship to each research question. The key themes that emerged from participants’ experiences receiving medications were limited knowledge of medication, adequacy of procedures taken, good physician communication about the patient’s health condition, limited physician communication about medication, and differences in nurses’ communication during medication administration. The main theme that emerged from participants’ descriptions of factors that encouraged the safe receipt of medications was that changes were needed to encourage MS. The changes included establishing a unified medical record, informing patients about medication side effects, encouraging shared decision-making about medication with patients, and ensuring nurses’ commitment to giving medication on time. Participants reported having a self-perceived role in MS and MS behaviors that hospitalized patients can practice in preventing MEs. Those behaviors were providing accurate and complete information to physicians, checking medication with nurses before receiving it, familiarizing themselves with medication, and reporting side effects. Two themes uncovered factors that influenced patients’ decisions to engage in MS behaviors. These included healthcare provider-related factors, represented by a lack of patient education to practice MS and lack of information offered to patients about medications, and patient-related factors, represented by patient health condition and patient desire. The themes revealed that HCPs’ behaviors, which empowered patients to engage in their MS, were communicating well with patients, educating patients about MS behaviors, and making medication information accessible to patients. HCPs have the potential to facilitate patient engagement in those MS behaviors among hospitalized patients. Thus, this study recommended that HCPs reevaluate their personal philosophies of patient engagement that may influence their behaviors to engage patients in MS. Future research is needed to understand HCPs’ views on hospitalized patient engagement with MS in KSA, develop an instrument to assess patient engagement in MS behaviors and explore hospitalized patient empowerment regarding MS from HCP perspectives.46 0Item Restricted MEDICATION ERRORS ASSOCIATED WITH DIRECT ACTING ORAL ANTICOAGULANTS IN ADULT PATIENT(Saudi Digital Library, 2023-08-14) Alrowily, Abdulrhman; Paudyal, Vibhu; Jalal, ZahraaDirect oral anticoagulants (DOACs) are effective therapeutic and/or prophylactic agents for thromboembolic events, such as deep venous thrombosis (DVT), pulmonary embolism (PE), and atrial fibrillation (AF). However, DOACs are also recognised as one of the most commonly concerned drug classes in relation to safety incidents. The purpose of this thesis was to determine the epidemiology of errors and explore the factors contributing to medication errors associated with DOACs from the perspectives of healthcare professionals and patients. The thesis consisted of three main parts: a systematic review and meta-analysis; two retrospective studies, and three in-depth qualitative interview studies. The systematic review and meta-analysis were conducted to determine the prevalence of medication errors associated with DOACs in clinical practice and to identify factors associated with DOACs in adult patients using published literature. Data related to error causation were synthesised using the Reasons Accident Causation Model. The systematic review and meta-analysis were conducted through searching 11 databases, including Medline, Embase and CINHAL, between January 2008 to September 2020. Thirty-two studies were included in the review. The proportion of the study population who experienced either prescription, administration, or dispensing error ranged from 5.3 to 37.3%. The pooled percentage of patients experiencing prescribing error was 20% (95% CI 15-25%; I2 = 96%; 95% PrI 4-43%). Prescribing error constituted the majority of all error types with a pooled estimate of 78% (95%CI 73-82%; I2=0) of all errors. The commonly reported causes were active failures, including wrong drug, and dose for the indication. Mistakes such as non-consideration of renal function, and error-provoking conditions, such as lack of knowledge, were common contributing factors. The second part of this thesis involved two retrospective evaluations undertaken using national and local hospitals’ incident reporting databases in Saudi Arabia and through using a national safety incident reporting database in the United Kingdom (UK). The purpose of this phase was to investigate the types of medication errors and contributory factors associated with DOACs. Using three datasets, including the National Food and Drug Authority (Saudi FDA) database, a total of 199 medication error incidents were analysed. The prescribing error was the most common error type, representing 81.4% of all errors. Apixaban was the most frequent drug associated with error reporting, with 134 (67.3%) incidents, followed by rivaroxaban (18.6%), and dabigatran (14.1%). In the UK, using the National Reporting and Learning System (NRLS) database, a total of 15,730 incident reports received by the NRLS between 01 January 2017 to 31 December 2019 were analysed. A total of 25 deaths were reported, with a further 270 and 55 incidents leading to moderate and severe harm, respectively. A further 8.8% (n=1381) of incidents were associated with a low degree of harm. The third part of this thesis consisted of three theory-driven qualitative studies exploring the views, experiences, and contributory factors related to DOACs medication errors from the perspectives of physicians (n=20), nurses (n=14), pharmacists (n=23), and patients (n=9) in Saudi Arabia. The participants were recruited from three different hospitals setting and regions. The analysis identified several themes: factors related to healthcare professionals (e.g., knowledge, lack of communication with other HCPs, confidence and access to guidelines, patient counselling); factors related to patients (e.g., comorbidity, polypharmacy, lack of knowledge of DOACs, using inappropriate sources of information and communication barriers with HCPs); factors related to the organisation (e.g., guidelines, safety culture and incidents reporting system); factors related to the DOACs medications (e.g., lack of availability of antidotes and dosing issues); and strategies for error prevention/mitigation and promote DOACs safety from staff and patient perspectives (e.g., empowering the role of pharmacists, patient education, opportunities for risk assessments, multidisciplinary working and enforcement of clinical guidelines and needed professional training and routine medication review). The data provided revealed convincing evidence in relation to the prevalence of errors and actual harm caused by such errors when prescribing, dispensing, and administrating DOACs. The key strategies to minimise errors associated with DOACs can be providing interventions to improve education and training of healthcare providers, developing local clinical guidelines, involving pharmacists to lead anticoagulation clinics, improving communication, and adhering to evidence-based strategies10 0Item Restricted IDENTIFYING FACTORS THAT AFFECT SAUDI NURSES’ INTENTIONS TO REPORT MEDICATION ERRORS IN ARAR HOSPITALS(Saudi Digital Library, 2023-12) Aldughmi, Ohoud; Bobay, KathleenBackground: Medication errors are common health safety issues in the Kingdom of Saudi Arabia (KSA). To avoid medication errors, Saudi hospitals need to identify the causes of such errors and encourage nurses to report them. Currently, most Saudi nurses do not report errors due to the Saudi blaming culture and fear of reprisal. Therefore, Saudi nurses need a psychologically safe environment that encourages them to admit and report errors. Identifying Saudi nurses’ perceptions, attitudes, norms, behaviors, and intentions regarding reporting medication errors will help Saudi healthcare organizations to support and encourage a reporting culture. Purpose: The purpose of this study is to identify factors that affect the intention of Saudi nurses to report medication errors. Method: A quantitative cross-sectional online survey method was used for this study. The study population is Saudi registered nurses who were working at the time of the study in medical, surgical, and intensive care units at Prince Abdulaziz Bin Musaad Hospital and North Medical Tower in the city of Arar in the KSA. The survey used in this study includes a theory of planned behavior questionnaire, a psychological safety scale, and demographic questions. The data analysis employed descriptive statistics, Pearson correlation coefficients, and hierarchical multiple linear regression to assess significant predictors of reporting medication errors. Internal consistency reliability was tested for the scales. Results: The results of this study confirm that Saudi nurses in two Arar hospitals have moderate intentions to report medication errors. The findings demonstrate that the theory of planned behavior constructs (attitude toward behavior, subjective norms, and perceived behavioral control) are significant predictors to explain Saudi nurses' intention to report medication errors. Psychological safety was not found to be a significant predictor in isolation, but it became a statistically significant predictor after interaction terms were added to the model. The interaction between attitude toward behavior and psychological safety was found to be negative and significant, but the interaction between subjective norms and psychological safety was found to be positive. The results indicated that the TPB survey had good reliability and internal consistency. Conclusions: The findings of this study may suggest that subjective norms and attitudes toward behavior are factors that should be assessed before implementing improvement interventions for reporting medication errors. However, further research with larger samples and various groups is necessary to determine significant predictors of Saudi nurses' intentions to report medication errors.37 0