Academic literature on the topic 'Critical care medicine Saudi Arabia'

Background and PurposeHypertension is rapidly increasing in the Kingdom of Saudi Arabia (KSA), particularly among men. Assessment of hypertension self-care behaviors is a critical step to promoting blood pressure control. This study aimed to evaluate the Hypertension Self-Care Profile (HBP-SCP) among Saudi men in KSA.MethodsThe HBP-SCP self-efficacy and behavior scales were translated into Arabic and tested on a convenience sample of 160 Saudi men with hypertension. Cronbach's alpha and factor analysis were conducted using SPSS.ResultsInternal consistency of the Arabic HBP self-care and self-efficacy scales was 0.84 and 0.90, respectively. Factor loading ranged from 0.25 to 0.70 for HBP self-care behaviors and from 0.28 to 0.77 for HBP self-efficacy.ConclusionsThe Arabic HBP-SCP is acceptable in its reliability and validity for measuring HBP self-care behaviors and self-efficacy among Saudi men with hypertension.

PURPOSE OF REVIEW: High-level nurse-doctor collaboration and competence reduce average hospital duration of the patient and mortality rates. Critical care unit plays an integral role as it integrates techniques and principles for ensuring high-quality care in a dynamic work environment. This study determines the status of critical care unit professionals, particularly nurses concerning their teamwork self-assessment. The descriptive correlational study design following a quantitative research design was used. Purposive sampling was employed for selecting 143 critical care unit nurses from Al-Ansar General Hospital, Saudi Arabia. A survey using a teamwork effectiveness self-assessment questionnaire was held for collecting data, which was then statistically analyzed. RECENT FINDINGS: Findings showed a significant and positive correlation between nurses’ interests and priorities with their job functions and problem-solving abilities. It showed that the manager’s support and guidance along with the nurse’s participation in decision-making helped the nurses to resolve critical problems and make rapid decisions in critical hours. SUMMARY: Nurses’ conflict management and effective time utilization were significantly and positively correlated. This provided physical and structural opportunities, adequate education and training, and a supportive environment to overcome problems impeding teamwork effectiveness.

Background Since the underlying cause of idiopathic short stature can indeed be undiagnosed mucopolysaccharidosis type I, it is critical to identify patients with mucopolysaccharidosis type I among screened patients with idiopathic short stature. Objective The primary objective of this study is to determine the prevalence of mucopolysaccharidosis type I disease in a high-risk group (ie, patients with idiopathic short stature). Methods We plan to perform a multicenter, cross-sectional screening study to primarily assess the prevalence of mucopolysaccharidosis type I disease in patients with idiopathic short stature. All eligible patients will be tested after obtaining written informed consent from their parents and guardians. Eligible patients will be recruited over 18 months from specialty care centers for pediatrics and genetics. Results This protocol was approved by the Institutional Review Board of King Fahd Medical City and funded by Sanofi Genzyme Saudi Arabia. We expect to collect data from ≥800 patients, as determined by our sample size calculation. Conclusions Saudi Arabia is the largest country in the Arabian Peninsula; it has a population of more than 28 million people. To date, there are no reliable data regarding the incidence and prevalence of mucopolysaccharidosis type I in Saudi Arabia; therefore, future multicenter studies will be needed. Further, the prevalence of an attenuated form of mucopolysaccharidosis type I is largely underestimated in Saudi Arabia due to the absence of an effective newborn screening program. Therefore, the implementation of a nationwide newborn screening program is essential for the accurate estimation of the burden of mucopolysaccharidosis and the early diagnosis of patients. International Registered Report Identifier (IRRID) PRR1-10.2196/28619

Introduction: paramedics conducting interfacility transfer of critically-ill patients is one of the existing models in interfacility transfer. The paramedic model is available in multiple countries, including the Kingdom of Saudi Arabia. Paramedics’ expanded scope of practice has allowed them to transport, monitor and intervene with complex patients. This PhD thesis is designed to evaluate the safety of the paramedic model in Saudi Arabia conducting interfacility transportation of critically-ill patients. Method: the PhD thesis is mixed methods. A systematic literature review was conducted to examine literature on the safety of paramedics in interfacility transfers. A retrospective chart review was conducted to examine the incidence, predictors and pattern of adverse events seen in interfacility transfers by paramedics in Saudi Arabia. Following this, a retrospective chart review of interfacility transfers by physicians to the same institution was conducted to compare in-hospital mortality and 30-days survival in both groups. Finally, an expert survey was conducted to examine the consensus of paramedics’ intervention to adverse events seen in interfacility critical care transfers. Results: the literature showed that the frequency of adverse events seen by paramedics in interfacility transfers ranges from 5.1% to 18%. The rate of adverse events in adult critical patients transferred by paramedics to a tertiary care facility in Saudi Arabia was 13.7%, in-hospital mortality was 30.4% and 30-days survival was 68.1%. There is no significant difference regarding in-hospital mortality or 30-days survival between the paramedic and physician models. The paramedics’ interventions in interfacility adult critically-ill patients were rated appropriate by the majority of the experts in 86.8% of cases; the probability of an intervention to be appropriate was 84.9%. Conclusion: paramedics with appropriate training and skill can safely transfer critical interfacility adult patients. The mortality outcomes in the paramedic model are comparable to the physician model.

Background: Saudi Arabia is one of the Gulf Cooperative Council (GCC) countries which have common characteristics such as high-income governments, dominant expatriate populations, and under-developed healthcare systems, including healthcare financing. The dominance of the expatriate working population raises the question of how to find a mechanism that ensures expatriates have appropriate access to medical care whilst the employers bear the responsibility of healthcare expenses. Saudi Arabia is one of the few GCC countries to have reformed its private healthcare system through a Compulsory Employment-Based Health Insurance (CEBHI). The CEBHI was designed to mitigate some of the disadvantages of the Employment Sponsored Insurance scheme previously implemented in the United States; and this is the first study to investigate the impact of this form of private health insurance on access to medical care, in a country such as Saudi Arabia. The main aim of the study was to explore the influence of health insurance on access to medical care, in order to assist the Saudi Government in their deliberations about making CEBHI compulsory for all people (citizens and expatriates) within Saudi Arabia. This aim was investigated through the following objectives: 1) to review health financing in Saudi Arabia and compare it with other GCC countries and elsewhere in the world; 2) to compare the access to medical care of insured and uninsured expatriates in Saudi Arabia; 3) to develop a framework for understanding the complex relationship of health insurance and access to healthcare, 4) to make policy-relevant recommendations regarding the key question as to whether compulsory health insurance in Saudi Arabia should be expanded. Methods: Two methods were used to tackle the study objectives. Firstly, a framework for country-level analysis of healthcare financing arrangements was used to compare and analyse the national expenditure on healthcare within the GCC and other developing/developed countries. Secondly, a logistic regression analysis of data from a cross-sectional survey was undertaken to investigate the impact of health insurance on access to medical care, considering the main workplace and personal characteristics of the expatriates. Three access measures, access to usual medical care (Access 1), inability to access medical care (Access 2), and utilization of medical care (Access 3), were used to evaluate access to medical care for the expatriate population. Prior to the implementation of CEBHI the expatriate population accessed medical care through a variety of different avenues. These modes of access were used as classification of the expatriate population into four groups. Two of these groups were insured but had a different Previous Method of Paying for Healthcare (PMPHC) (Group B=insured, not paid, and Group D=insured and paid) and two groups were not insured but also had different PMPHC (Group A=not insured, not paid and Group C=not insured, but paid). A multistage stratified cluster sampling was used, and a sample selected from each sector and company size proportionately. The total sample size was 3,278. A simple conceptual framework for studying access to medical care was developed to guide the multi-variate regression techniques, and greatly assisted interpretation of the results. Results: The GCC characteristics impact on the healthcare financing strategies of GCC countries in three ways. First, GCC governments provide the majority share of the health budget, similar to high-income countries. Second, GCC countries use different strategies to control expatriates costs, but some of these strategies lead to increased out-of-pocket expenses, which is a characteristic of low-income countries. Third, health care financing systems in GCC countries are still being developed as they finance most of their public services, including health care services, with revenue from natural resources (i.e. oil or gas). Additionally, some of their health care indicators are identifiable with those from below upper-middle income countries. In addition, after CEBHI, private expenditure did not change but remained around 22.4%, which does not reflect the huge number of people having access to medical care though private sector only. However, there was a shift in the means of private sector expenditure from Out Of Pocket payments to private insurance expenditure. OOP expenditure decreased from 32.3% in 2006 to 28.4% in 2008, and private insurance expenditure increased as a percentage of private sector expenditure from 26.2% in 2006 to 36.7% in 2008. Analysis of the data from the survey demonstrates that health insurance is strongly associated with access to medical care, as measured by the three different access measures). Compared to uninsured workers, being enrolled in CEBHI increased the possibility of an expatriate’s access to usual medical care and utilisation of medical care by more than 10 (8.709-12.299, 95%), and 2.3 (1.946-2.750, 95%) respectively. However, the influence of PMPHC is greater than the influence of insurance alone on reducing the inability to access medical care (health insurance reduced the inability to access medical services by 42% (0.515-0.995, 95%), whereas PMPHC reduced the inability to access medical services by more than 65.% (0.273-0.436, 95%)).Therefore, the impact of health insurance on access to medical care is much greater for those expatriates previously having had healthcare costs met by their employer, than for those who had not. These impacts remained, when the odds ratios were adjusted for both workplace and personal characteristics. Conclusion: CEBHI has a clear positive impact on reducing out of pocket payments and increasing private insurance expenditure. However, overall, private healthcare expenditure has increased insignificantly. This indicates that the main impact of CEBHI on private expenditure, is the change in the mode of payment from out of pocket payments to private insurance expenditure. However, the actual impact on private sector expenditure is still minor. Access to medical care is influenced by health insurance. In addition, it is also influenced by PMPHC as a contributory role to play in the influence of health insurance on access to medical care. Workplace and personal characteristics play a small part in mediating the influence of health insurance on access to medical care. A framework was developed for understanding the complex relationship of health insurance and access to healthcare, which will be useful for further investigations regarding the influence of health insurance on access to medical care. Both long and short-term recommendations are proposed for increasing the expatriate population’s access to medical care, whilst reducing the burden on healthcare financing.

Recent health care reforms within Saudi Arabia have advocated use of economic evaluation in health care decision making. Little research has, however, considered the use of economic evaluation to set priorities in rentier state settings. This thesis explores the nature of the rentier state and the basis of health care priority setting, and conducts a systematic review of the use of economic evaluation in priority setting. The thesis uses in-depth qualitative research to explore health care priority setting and use of economic evaluation in Saudi Arabia. Qualitative data comprised 22 in-depth interviews with decision makers at the national and district levels, 3 focus groups, and one meeting observation. Data collection and analysis were conducted iteratively using constant comparison. Findings show that contextual factors have a great influence on the decision making process and that the use of economic evaluation is still very limited. There appeared to be two types of barriers to the use of economic evaluation: decision context-related barriers and barriers relating to the production of economic evaluation data. Incorporating economic evaluation into the health care decision making process in Saudi Arabia is proving to be complex and contextual factors have more influence on priority decisions than economic evaluation.

Despite increased awareness about patient safety and quality of care, errors and adverse outcomes occur frequently in clinical practice. An estimated 10% of the 35.1 million U.S. hospital patients suffered injuries caused by medical errors; the most common were medication errors, which accounted for more than 50% of all medical errors. Work-related stress is associated with medication errors for health care professionals (HCP) in Saudi Arabia (SA) hospitals; however, the specific types of stressors and their effect on the level of medication errors have not been studied in SA. The purpose of this quantitative correlational study was to examine the relationship between the overall level and sources of work-related stress using the job stress scale on the level of medication errors for a group of 269 HCPs working at King Abdul-Aziz Hospital (KAH) in SA. The theoretical framework for this research was the Donabedian patient safety model, which relates healthcare quality to personal, environmental, and organizational factors. Binary logistic regression analyses indicated there was no relationship between overall levels of stress and medication errors. However, specific sources of work related stress such as disruption to home life, excessive workload, and night/weekend call duties were associated with a significant increase in the medication error rate, while pressure to meet deadlines and difficulties with colleagues was associated with a significant decrease in the medication error rate. Positive social change implications include how understanding the impact of work-related stress on medication errors by SA HCPs may lead to specific interventions to reduce medication errors and improve patient care.

Technological innovations have been shown to improve the quality of health information and improve safety in health care systems. The purpose of this project was to offer hospital nurses a more flexible and practical alternative to education and training than the traditional face-to-face method, supporting nurse educators in overcoming many of the obstacles in responding to nurses' needs in the clinical areas. This project used a randomized, 2-group posttest-only experimental design to measure the effect of treatment at a targeted hospital. The experimental group received a new instructional approach using an Electronic Learning Management System (ELMS) and the control group used the site's traditional standard method; both groups completed the Posttest Knowledge Assessment. The study population consisted of registered nurses who had attended the project site's Safe Blood Transfusion Practice program over a period of 1 month. There were no significant differences between the 2 groups' members' gender, age, level of education, or nursing experience. Data analysis showed a significant (p < .00) difference between the 2 groups' posttest scores, indicating that the participants who used the ELMS attained a higher median knowledge (M = 89.39, SD = 9.26) than did participants who received traditional, face-to-face instruction (M = 76.85, SD = 10.628). These results suggest that ELMS-based learning is a more effective method of instructional delivery that could effectively replace many of the traditional face-to-face education programs. Implementing this innovative system will create positive social change on the targeted hospital by improving health care delivery. The application of the finding would support clinical educators to improve educational delivery to their clients at the clinical areas.

The aim of the study was to describe the perceptions of critical care nurses concerning family witnessed resuscitation, presenting arguments for or against the practice thereof. A quantitative, descriptive and exploratory approach was used. For the study, a non- probability convenience sample of 100 critical care nurses from five critical care units were used. A combined open-ended and closed-ended questionnaire was used. The majority of critical care nurses in the study disapproved of the idea of family witnessed resuscitation. They believed it to be traumatic for relatives, threatening to the resuscitation process and increasing litigation. Although the dominant feeling was one of disapproval, some critical care nurses felt that family witnessed resuscitation was beneficial to relatives. Recommendations for future practice included incorporation of educational programmes for critical care nurses concerning family witnessed resuscitation and providing training to deal with the stresses of family witnessed resuscitation.
Health Studies
M.A (Health Studies)

Introduction: Health care professionals, including registered nurses are prone to stress, with new graduates experiencing high levels of stress in their graduate year. In Saudi Arabia many new graduates are expected to be placed in critical care units due to a range of contextual issues. These units are stressful; effective ways to assist these new graduates are required. Simulation learning is envisaged to be a novel strategy to overcome this issue. Reducing stress levels in new graduates assists them to transition to professional practice and has the potential to improve workforce demands by increasing retention. Thus, this research explored both stressors among new graduate registered nurses (RNs) in intensive care units (ICUs) and the potential use of a complex intervention using simulation to reduce these stress factors. For the purpose of achieving the aim of this study, the research was based in one hospital in Saudi Arabia, the King Saud Medical City- Riyadh (KSMC-R). It is also noteworthy that the complex intervention was designed and will be implemented and evaluated in future research. Objective: This study aimed to design a simulation based learning exercise (SBLE) based on the specific stressors experienced by new graduate RNs working in the paediatric and adult ICUs at KSMC-R. Methods: This research was based on an interventional mixed method design. The research involved the integration of three studies which incorporated both quantitative and qualitative approaches, whereby a sequential exploratory design was employed. Study 1: Survey of new graduate RNs in which 189 Saudi new graduate RNs were surveyed about their experiences of stress in their ICUs units using the Perceived Stress Scale (PSS) to measure the level of stress and the Expanded Nursing Stress Scale (ENSS) that measured the factors/frequency of stressors experienced by new graduate RNs in the ICUs. Study 2: Individual interviews of 10 new graduate RNs further explored their experiences of stressors in ICUs. Study 3: a single group discussion with 5 nurse educators investigated the extent and type of educational support provided for new graduates and educators’ views of and experience with simulation. Results: The results from the three studies were integrated using complementarity and triangulation techniques. From the results a complex intervention based on SBLE was designed to potentially assist new graduates to better manage and overcome these stressors. Conclusion: This research has contributed new knowledge regarding the level and nature of stressors that are experienced by Saudi new graduate RNs working in critical environments such as the ICUs. In addition the study offers a potential intervention to assist new graduates to deal with these stressors. The approach of using multiple data sources to inform the design of an SBLE has the potential to be used in other contexts.
Thesis (Ph.D.) -- University of Adelaide, School of Nursing, 2018

ICHSMT’21 is the fifth version of the International Congress of Health Sciences and Medical Technologies. The congress attended the success of regrouping a multidisciplinary community working with the challenge to add a relevant increment to the medical innovation and findings. The congress is a successor of four successful versions established respectively in 2016 (at Tlemcen University Algeria), 2017 (at Mariott Hotel Tlemcen Algeria), 2018 (at CERIST Algiers Algeria), and 2019 (at Zianides Hotel Tlemcen Algeria). After several delay and for the first time, an online edition was established due to critical situation of worldwide pandemic, which make the end of millions of peoples life. The congress is held between 27 and 29 June 2021, only online but the organization was at Tlemcen. The congress at that edition attracted researchers from several nations and specialties naming: Algeria, Germany, Iran, Switzerland, Netherland, Denmark, Malaysia, China, Portugal, Bulgaria, Pakistan, France, Morocco, Tunisia, Brazil, United Kingdom, Egypt, India, Poland Iraq, and Kingdom of Saudi Arabia. The congress author’s affiliations were from several departments such as medicine, biology, physics, chemical sciences, computer science, environment, pharmacy, dentary surgery, electrical and electronic engineering, and mechanical engineering. The content was selected via strong criteria applied by the members of program committee. We received 63 submissions, which were reviewed by 2-3 reviewers, and we accepted 59, the rate of acceptance was 80.95%. Only some abstracts are selected for publication in this book.

This article aims to develop an extension access control models framework in Saudi Arabian healthcare systems. The conceptual framework acts as an ascendency structure to organize and support the efforts of several health care standards which reflect on the coherent of confidentiality; integrity; and availability triads in order to achieve the strategic business objectives of Saudi Arabian healthcare institutions. It is considered to be three common access control models developed by ACM institute and extended to other criteria identified by the National Institute of Standards and Technology. While literature explains that an easy-to-use access control model can lead to success healthcare system, understanding the extension of access control systems is vital for Saudi Arabian healthcare institutions to protect resources against unauthorized use. This article has taken a step in this direction.