Volume 9, Issue 1

The Effect of Central Venous Catheter Maintenance Bundle Implementation on Central Line Associated Infection Rate in the Intensive Care Unit
Original Research
Background: Central venous catheters (CVC) play an important role in the treatment of hospitalized critically ill patients. To improve patient outcome and to reduce healthcare costs, there is considerable interest by healthcare providers in reducing the incidence of Central line associated blood stream infections. OBJECTIVE: This study aims to evaluate the efficacy of the implementation of CVC bundle to all patient admitted in intensive care unit with central line on the reduction of the rate of central line associated blood stream infection. SETTINGS/DESIGN: Quasi-experimental before and after study design conducted in intensive care unit of King Abdullah Medical City, Makkah. SUBJECTS AND METHODS: This study was targeting all patient with central line in intensive care unit. At the time of central line insertion bundle was initiated and maintained until the removal of central line over 12 months period started on December-2018 and ended on December-2019. RESULTS: Study result show a significant reduction (77%) of CLABSI rates, before and after CVC maintenance bundle implementation, which show the effectiveness of bundle implementation on ICU patient and also there is improvement in site selection, subclavian site selection has been increases to 27% during post bundle period compare to 9.5% before pre bundle period, so this improvement may have some impact on the result of CLABSI. Despite study intervention there was slight improvement in insertion bundle compliance rate increase from 89% to 96% over twelve months during study period. CONCLUSION: The study found the effectiveness of central line bundle implementation on ICU patient; this result been achieved with presence of high compliance to the element of bundle by ICU nurses. Looking to CLABSI cases before and after bundle implementation, variable which been observed were close to each other.
American Journal of Nursing Research. 2021, 9(1), 29-34. DOI: 10.12691/ajnr-9-1-5
Pub. Date: December 07, 2020
293 Views175 Downloads2 Likes
Exploring Strength Areas of Patient Safety Culture Improvement in KAMC, Makkah, Saudi Arabia
Original Research
Background: Patient safety culture is an extremely important aspect and a crucial issue in health services. Assessing patient safety culture is a fundamental in obtaining first-hand information on healthcare settings that will help to identify positive areas and shortcomings in patient safety practices that require future improvement. Objective: This study aims to investigate the strengths area of patient safety culture improvement. Also, this study evaluates employees’ perceptions concerning patient safety culture. Subjects and Methods: A mixed methodology and cross-sectional design was used to achieve the aim of the study. Hospital Survey on Patient Safety Culture questionnaire was used to collect data from 350 front line health care providers at specialized hospital, Makkah, Saudi Arabia. Results: The highest rated Patient safety culture dimensions from health care staff perspective was teamwork within units and across the unit, supervisor/ manager expectations and actions promoting patient safety and over all perception of patient safety. The lowest rated dimension was non punitive response to errors, Communication openness, and frequency of events reported. The most of the participants given excellent or very good score in overall patient safety grade, and the majority of the respondents never reported any events during last 12 months. The study statistically proved the relationship between patient safety culture and area of work and number of events reported. In this study result showed that there is significantly difference exist between 12 dimensions of composite items with patient’s safety culture. Conclusion and Recommendations: This study found the strengths and areas of improvements of patient safety culture in the hospital. The good leadership support, effective communication, sufficient staffing, team work, open communication about errors and adequate working hours can improve patient safety culture. This study recommends the health care leaders to create an institutional strategic plan to improve patient safety programs in hospital settings.
American Journal of Nursing Research. 2021, 9(1), 20-28. DOI: 10.12691/ajnr-9-1-4
Pub. Date: November 29, 2020
357 Views229 Downloads
From Protocolization of Care to Nursing Care Practice: A Qualitative Research
Original Research
This qualitative research tries to understand experiences and meaning that nurses have about nurse care protocols, since its nature, advantages, or disadvantages. Methods: some elements of ethnography were used for data recollecting, and grounded theory was used for analyzing information, 7 nurses, with wide experience in protocols development and implementation, were interviewed. Results: the main categories were that protocols are necessary, but in some cases, nurses do not follow protocols and nurses follow them excessively, in both cases, a care deconstruction takes place, results were analyzed from Betty Neuman theory. Conclusion: protocols should be rethought, they might be called just guidelines, nurses should think systematically and critically, caring is more than following protocols, when nurses just do what protocols suggest, they are not caring, they are breaking the care as a concept and as a practice, nurses have to care of caring in order for caring people.
American Journal of Nursing Research. 2021, 9(1), 15-19. DOI: 10.12691/ajnr-9-1-3
Pub. Date: November 26, 2020
311 Views190 Downloads
Effect of Six Hats Thinking Technique on Development of Critical Thinking Disposition and Problem Solving Skills of Nursing Students
Original Research
Background: Six Thinking hats is a time-tested, proven, and practical thinking tool that acts as a role-playing model. It is as a team-based problem solving and brain storming technique that can be used to explore problems and solutions and uncover ideas and options that overlooked by a homogeneously thinking group. On the same line, it separates the components of thinking in order to do them properly as there is no one brain ideal for all types of thinking. Also, it provides a framework to help people think clearly and thoroughly and directs thinking attention in one direction at a time. Edward de Bono identified 6 types of one-dimensional personalities or Thinking Hats, while the average person will often imbue qualities from several of these 6 types. Participants put on hats in turn to indicate directions of thinking, possibly more than once but not necessarily all of them, the color of each is related to a function. Method: exploratory descriptive design was used with two tools used in data collection” California Critical Thinking Disposition Inventory” and “Six Hats problem solving Application questionnaire”. Results: There were statistical significant differences between both groups of students in relation to critical thinking disposition and problem solving skills in post assessment phase in the favor of study group (p < .001). Conclusion: In the current study, the six hats technique was used in training of nurse students to improve their critical thinking disposition and the skills of problem solving, which facilitates productive critical thinking, collaboration, communication, creativity and enables each person's unique point of view to be considered in problem solving
American Journal of Nursing Research. 2021, 9(1), 8-14. DOI: 10.12691/ajnr-9-1-2
Pub. Date: November 24, 2020
234 Views133 Downloads
Nurses’ Knowledge, Perception, and Attitude towards Evidence-Based Practice at King Abdullah Medical City-Saudi Arabia
Original Research
Background: Health care organizations consider evidence-based practice as the gold standard for the provision of safe and compassionate health care. Aim of the study: The present study aims to assess the knowledge, perception, and attitude of nurses regarding evidence-based practice. Subjects and Methods: A descriptive design was utilized to achieve the aim of the study. The study included a random sample of (262) staff nurses who were responsible for providing nursing care to patients. Data were collected using three scales; knowledge scale, perception scale, and attitude scale regarding evidence-based practice. Results: The majority of the studied nurses had the knowledge and negative attitude regarding evidence-based practice and two-third of the studied nurses had a moderate level of perception regarding evidence-based practice. There was a statistically significant relationship between nurses’ knowledge and their educational qualification and there was a statistically significant relationship between nurses’ perception and their gender, educational qualification, and experience. Conclusion: There was a significant relationship between nurses’ Knowledge, perception, and attitude towards evidence-based practice. Recommendations: Nursing managers should develop an evidence-based practice training program to help nurses to be familiar with EBP steps. Nursing managers should motivate the nurses who follow up the EBP with different incentives.
American Journal of Nursing Research. 2021, 9(1), 1-7. DOI: 10.12691/ajnr-9-1-1
Pub. Date: November 15, 2020
321 Views207 Downloads