Saudi Cultural Missions Theses & Dissertations
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Item Restricted Factors Influencing Critical Care Nurses’ Attitudes to Patient Safety: A Systematic Review(QUEEN’S UNIVERSITY, BELFAST, 2024-09-08) Alduways, Saleh; Claire, KerrBackground: Ensuring patient safety continues to be a key aspect in the health sector. Negligent practices concerning health, hygiene and diet are among the top killers in modern society. The attitudes and practices of critical care nurses concerning patient safety culture are of significant importance. Safety culture refers to the safety beliefs, values and attitudes adopted by health care providers, as well as the processes of practising them and the dedication to creating a riskless health care system. Aim: This systematic review seeks to summarise the attitudes and practices of critical care nurses towards patient safety in ICUs and their adherence to international safety goals, and factors that affect their attitudes and practices towards patient safety practices. Methods: A systematic literature search was conducted in four online databases – CINAHL, MEDLINE, PubMed and Scopus – of publications spanning September 2014 to 2024. The PICo framework was employed in the formulation of the research question. Specific criteria were set for the inclusion of studies. The quality of the included studies was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS). Results: Ten studies were included in this systematic review. These studies employed cross-sectional design to investigate critical care nurses’ attitudes, perceptions and practices about patient safety, compliance with international safety goals, and factors that may influence them in critical care settings. In general, critical care nurses reported significant negativity in safety culture, and the management perception scores were low overall. Organisational commitment and job satisfaction had the highest means of positive scores as did teamwork. Nurses likewise confirmed a perspective of International Patients Safety Goals (IPSGs) as a reliable framework for patient safety; individual factors affecting patient safety culture included fatigue, workload and emotional exhaustion. Nurses aged 31–35 were more knowledgeable about the IPSGs. Conclusion: The current study reveals that critical care nurses had negative perception towards safety culture and poor response on the management support and the implementation of some principles of patient safety. Although 8 nurses’ knowledge of specific goals is strong, a number of implementation challenges remain and thus require focused interventions to enhance safety culture.29 0Item Restricted The Views and Experiences of Registered Nurses in Delivering Trauma Care as a Result of the Conflict at the Saudi Southern Border(Queen’s University Belfast, 2024-01) Sadhaan, Abdullah Faisal; Brown, MichaelBackground: Registered Nurses (RNs) provide care and support for patients affected by major traumatic injuries and can be challenged in meeting their physical, cognitive and emotional demands. RNs in trauma care settings are often exposed to threats and fear that affect them personally and professionally. RNs may lack the proper support to meet their emotional needs because of caring for trauma patients. Therefore, it is necessary to gain an understanding of their views and experiences to improve the clinical and personal experiences of trauma RNs serving in the Intensive Care Units (ICU) and Emergency Departments (ED) located in hospitals in the conflict zones along the Saudi-Yemen border. Aim: To identify the views and experiences of RNs providing care for patients requiring trauma care at the Saudi southern border because of the conflict. Methodology: A qualitative method using Thematic analysis (TA) was adopted to gather insights from the respondents. The thematic analysis used a homogeneous purposeful sample from a population of RNs working in the ED and ICU. Semi-structured interviews with 12 RNs were used to collect data while the insights gathered were analysed using the thematic analysis method developed and supported by Braun and Clarke (2006). Findings: The qualitative study established varied views and experiences of the trauma care RNs provide while working in the ED and ICUs. The RNs offered timely trauma care for the injured patients in the conflict zone along Saudi-Yemen border. The findings showed the views and experiences encompassed trauma care provision, education and practice development of RNs, barriers, and solutions to the barriers to the provision of trauma care. The views and experiences of the RNs about trauma care in the ED implied the existence of different models of trauma care. Their role in providing trauma care and the challenges in the ED such as communication barriers, teams or lines of communication, patient advocacy and support, and practice development for the dedicated intensive care operations. The models of trauma care mentioned by the xii respondents were ATLS model of trauma care, Canadian triaging system, and the team- oriented system of delivering trauma care. On the other hand, ED RNs faced challenges of organisation and resourcefulness and inadequate use of international trauma protocol standards. Education and practice development needs of the ED RNs were integral to the experience of delivering quality trauma care. Additionally, the primary barriers included professional, environmental, and organisational obstacles. The RNs described solutions to the barriers such as infrastructural changes, proper education and development, holding debriefing sessions, and development of trauma care teams. The analysis gathered that the ICU RNs had diverse views and experiences on trauma care for the patients from the Saudi-Yemen border. The themes from the analysis included building confidence, gathering or sharing knowledge, and understanding of offering trauma care in the ICU. The themes further include nurse-patient ratio, communication, proper organisation, and resource provision to the trauma RNs. Other findings discovered that the organisation and resource encompassed concerns such as staff shortage, excessive workload, and language barriers. Conversely, the key facilitators of trauma care in the ICU included teams or lines of communication, practice development for the RNs, and support from the hospital management through the equipment, and materials. The major practice and development needs found from the respondents included continuous learning and ATLS-based guidelines. However, the key barriers to trauma care delivery in the ICU include insufficient specialist trauma centres, a high number of trauma patients, and security threats. The ICU RNs proposed solutions such as access to education and practice development, access to the organisational resources, evidence-decision- making, workforce management initiatives, family and patient involvement, protocol and policy development in the ICU. Discussion and Conclusion: The discussion of the key findings was anchored on moral injury theory. The theory denotes the disturbing social, professional, behavioural, and psychological exposures affecting the trauma RNs’ moral beliefs and individual values. The RNs providing trauma care to patients from the conflict zones faced challenges and experiences that deviated from their moral beliefs, particularly within the context of their xiii nursing practice. The suffering at the patient and professional level altered the nurses’ views, social acceptance, connectedness, belonging, trust, and ability to engage with the practice. The study concludes that RNs in the ED and ICUs need additional courses, resources, security, debriefing sessions, incentives to work in the conflict zones. Future studies should use longitudinal designs to identify the effectiveness of overtime pay and hardship allowances in reducing the turnover rates of RNs serving in conflict zones.38 0