Saudi Cultural Missions Theses & Dissertations
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Item Restricted Clinical Dental Iatrogenesis: A Scoping Review(University College London, 2024-09) Alsharyoufi, Suha; Watt, Richard; Tsakos, GeorgiosBackground Iatrogenesis, which refers to the unintended harm caused by medical or dental interventions despite the well-intentioned actions of healthcare providers, is a significant issue in healthcare. While the medical field has extensively documented iatrogenesis, the dental field lacks comprehensive research on the causes, extent, and prevention of these harms. Understanding iatrogenesis in dentistry is crucial for improving patient safety. Aims The aim of this scoping review was to provide a comprehensive understanding of iatrogenesis in clinical dentistry. The review sought to identify the nature and causes of iatrogenic injuries, evaluate their impact on patient safety, and explore potential policy implications to minimise their occurrence. Methods A scoping review was conducted. Relevant studies were identified through a systematic search of the MEDLINE database, focusing on literature published between 2000 and 2024. Studies were chosen based on specific criteria. The data extracted from these studies were synthesised to map the different aspects of dental iatrogenesis. Results The review identified fifty studies of different designs that met the eligibility criteria, revealing a wide range of iatrogenic injuries across various dental specialities. These injuries were related to preoperative procedures such as inadequate staff-patient communication, errors in diagnosis, inadequate documentation of patient history and treatment plans, and suboptimal treatment planning that fails to consider all patient-specific factors. Intraoperative and postoperative complications encompassed damage to both soft and hard tissues, and technical failures causing minor infections to severe, life-threatening conditions. The occurrence of these injuries was influenced by various factors, including the clinician's experience, patient-specific characteristics such as age, medical history, and anatomical variations, as well as the inherent risks associated with the procedures. Conclusion The findings of this review highlighted the need for additional empirical longitudinal research to understand the long-term impact of dental interventions, the nature and causes of iatrogenic injuries, and to develop standardised guidelines aimed at reducing such injuries. Enhancing professional development, adhering to evidence-based practices, and fostering a patient-centred care approach are critical to improving patient safety in dental settings.15 0Item Restricted A Systematic Review: What Impact Did the Central Board for Accreditation of Healthcare Institutions (CBAHI) Program Have on Healthcare Outcomes in Tertiary and Secondary Hospitals in Saudi Arabia from 2014 to 2024?(University of Leicester, 2024-09) Jad, Rosa; Armstrong, NatalieBackground: Saudi healthcare has massively developed recently, spurred by immense investment and service user population changes. Saudi healthcare institution standardization by the “Central Board for Accreditation of Healthcare Institutions” (CBAHI) enforces stringent accreditation specifications addressing various dimensions to improve service and care quality and patient and staff safety, but few studies have explored specific outcomes. Aim: this study aims to explore the full picture of which impact CBAHI-A has on multiple healthcare outcomes in the context of these healthcare institutions in Saudi Arabia from 2014 to 2024. Study Design: Systematic literature review with narrative synthesis. Setting: Secondary and tertiary Saudi hospitals. Methodology and Methods: A systematic review as per “2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines, with a systematic literature search and analysis with analytical narrative synthesis. Results: Accreditation by CBAHI achieves specific enhancements in the quality and safety of care, as reflected in fewer errors in medication and improved infection guideline compliance. Nevertheless, mixed findings were reported for the rate of mortality and hospitalization duration, suggesting more modest net impacts on core indicators. Differing levels of enhancement were reported for service user satisfaction and resource deployment efficiency. Conclusion: CBAHI accreditation significantly enhances certain outcomes for care and safety quality in Saudi secondary and tertiary hospitals, but it does not produce substantive, provable breakthroughs in important clinical and organizational indicators. Ongoing monitoring and studies are needed, especially longitudinal ones over time, and studies of specific factors of Saudi contexts.5 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 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 0Item Restricted Patient Safety Reporting and Learning systems in the Kingdom of Saudi Arabia: A scoping review of lessons learned from the experiences of developed countries(2023-05-19) Alshanbari, Ghadeer; Needham, CatherineBackground: Health organisations in the Kingdom of Saudi Arabia (KSA) are aggressively pursuing measures to improve the quality and safety of healthcare services in response to the growing awareness of patient safety incidents (PSIs) and increased public pressure and media attention. In 2017, policymakers in the KSA created the Saudi Patient Safety Center (SPSC), which fulfils one of the initiatives of the National Transformation Vision 2030. In 2018, the centre was assigned to deliver the first National Patient Safety Reporting and Learning System, which is called ‘‘SAWTAK’’, to all healthcare sectors. However, the KSA is considered to be in the early stages of adopting SAWTAK. It has been found that there is a knowledge gap in patient safety research in KSA, especially about these systems and their implementation mechanism, because they are relatively new. Objective: To explore lessons from developed countries' experiences in implementing incident reporting systems (IRSs) to maximise success and improve the adoption of such systems in the context of the Kingdom of Saudi Arabia. The research question that this dissertation seeks to answer is as follows: What lessons can KSA learn from the experience of developed countries in implementing electronic incident reporting and learning systems? Study Design and Methods: A scoping review (SR) was conducted in August 2022 in two databases, the Web of Science and Google scholar. Additionally, the reference lists of the included studies were also manually searched. The selection of studies was based on pre-defined eligibility criteria. The review was limited to peer-reviewed studies published between 2000 and 2022, and non-English content was excluded. The literature was synthesised using a descriptive summary and a thematic analysis. Findings: Eighteen publications were included for the review from seven developed countries, and the highest contributing studies were from the United Kingdom (UK). The review found many factors that can contribute to successful implementation, such as collaborative implementation efforts within and outside the organisation, avenues to increase employee engagement such as feedback and visible actions, training and education programmes, safety culture and effective leadership, as well as enablers related to system design and availability of financial resources and time. The results were interpreted from a socio-technical perspective and in the context of the current literature. It also highlighted the significant role of leadership and other organisational factors in implementation. Conclusion: The research concludes that introducing reporting systems or procuring new technology is insufficient to create a culture of patient safety and organisational learning. Instead, it entails significant changes in a complex system with many interrelated components that must work together to achieve an intended goal. The KSA should consider the common organisational factors reported in this review that help the successful implementation. Recommendations were proposed for the KSA based on the factors identified in this review and should be targeted for the successful implementation of the IRS.22 0