Interprofessional Cooperation: An Interventional Study Among Saudi Healthcare Teaching Staff at King Saud University

Nurses' ethical responsibilities: Whistleblowing and advocacy in patient safety

BACKGROUND

In the dynamic landscape of healthcare, nurses play a crucial role as ethical stewards, responsible for whistleblowing, nurse advocacy, and patient safety. Their duties involve ensuring patient well-being through ethical practices and advocacy initiatives.

AIM

This study investigates the ethical responsibilities of nurses regarding whistleblowing and advocacy in reporting concerns about patient safety.

RESEARCH DESIGN

A cross-sectional study utilized cluster and simple random sampling to gather a representative sample of actively practicing registered nurses. Data collection involved a demographic form, Nurse Whistleblowing Intentions Scale, Nursing Advocacy Scale, and Clinical Decision-Making Scale.

PARTICIPANTS AND RESEARCH CONTEXT

The study utilizing a robust sample size determination formula for reliable findings included 96 diverse nurses, predominantly females. Engaged actively in direct patient care across various outpatients clinics. The recruitment process specifically sought individuals with expertise in safety protocols and reporting, contributing to a nuanced understanding of the study's focus.

ETHICAL CONSIDERATIONS

Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. A thorough ethical review was conducted to guarantee participant protection and adherence to ethical principles.

RESULTS

Surveyed nurses demonstrated positive whistleblowing (Overall Mean Score: 3.58), high advocacy (Overall Mean Score: 12.2), and nuanced ethical decision-making for patient safety (Overall Mean Score: 15.78). Demographic factors, such as nationality and ethical training, significantly impacted whistleblowing intentions, while age, gender, and ethical training correlated with nursing advocacy behavior. Associations with experience and qualification emerged in ethical decision-making.

CONCLUSION

The gained insights foster targeted interventions, improving ethical practices, advocacy, and informed decision-making in nursing. This study explores the intricate link between demographics and ethical considerations among surveyed nurses, acting as a catalyst for ongoing initiatives to strengthen the ethical foundation in healthcare sector.

University Staff Insights on Interprofessional Education and Student-Led Clinic Opportunities at an Australian University

Purpose

Organizational and university staff buy-in and advocacy are critical considerations in planning successful interprofessional education (IPE) initiatives in healthcare, such as interprofessional student-led clinics (SLCs). This study was designed with the purpose of gaining deeper insight into current views and perspectives of academic and professional staff at an Australian university, as a precursor to planning IPE and SLC activities.

Methods

All academic and professional staff from within the School of Health Sciences were invited to participate in the study. In-depth-qualitative interviews were conducted with 16 staff to explore academic and professional staff perspectives on IPE and SLCs. Reflexive thematic analysis was used to analyse the data.

Results

Findings are grouped within five themes that incorporate broad perspectives on the tensions and possibilities of IPE and establishment of SLCs: Academic and professional staff commitment; Better/smarter IPE; Student-led clinic potential; Vision and innovation; and Strategy and resourcing. The themes reflect the high value placed on IPE by academic and professional staff and incorporate innovative ideas on how to prepare students for a rapidly changing and evolving healthcare environment. A reticence towards standard models of university based SLCs was expressed.

Conclusion

Academic and professional staff insights suggest university leaders need to develop a greater strategic focus on improving IPE. Effective engagement with staff is required to support IPE planning and implementation. If considering implementation of SLCs, contemporary fit-for-purpose models should be explored such as partnerships with primary healthcare providers, community wellness facilities, and hospital clinics rather than traditional university-based clinics.

A Qualitative Study of Stakeholders' Perspectives of Implementing Interprofessional Shared Decision-Making Education in Palliative Care

Introduction Shared decision-making (SDM) in palliative care is a highly complex process that requires an interdisciplinary team. Interprofessional team members need education on how to facilitate discussion of patient/family wishes at the end of life in hospital settings. So far, interprofessional shared decision-making (IP-SDM) education frameworks have been used to a limited extent in the area of education on palliative care. The aim of this study was to explore policymakers', health professionals', faculty members', and students' perspectives on implementing an IP-SDM educational framework in palliative care to identify aspects that should be prioritized to further develop interprofessional education for SDM in palliative care. Methods We used the qualitative method to capture the micro, meso, and macro factors using Oandasan and Reeves' model for the implementation of IP-SDM education regarding palliative care. Data collection tools included in-depth, face-to-face interviews with individual policymakers and focus group interviews with health professionals, faculty members, and undergraduate health professionals. The interview guide explores the teaching of SDM in palliative care, factors that could facilitate or hinder the implementation of IP-SDM education for health professions students in palliative care, and interventions to facilitate the implementation of this approach. This study was conducted at the Oncology and Palliative Care Department at King Abdulaziz Medical City in the Ministry of National Guard Health Affairs and at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia. Results The results indicated a high demand for IP-SDM in palliative care. The findings revealed factors that can facilitate or hinder the implementation of IP-SDM education in palliative care for undergraduate health professions students that is going to the local community. Factors include culture, religion, gender, power issues, team hierarchy, and respect among team members. Also, our findings have revealed potential solutions to the hindering factors. Conclusions IP-SDM education in palliative care is a highly relevant topic for improving patient outcomes. However, it might be a complex process to implement, especially given the challenges of palliative care settings. We recommend starting such a course in the early clinical phases of undergraduate health professional education.

Patients' Perspectives of Interprofessional Collaboration in Breast Cancer Unit

Interprofessional teamwork provides significant benefits for patients. However, qualitative research on interprofessional collaboration in the breast cancer unit is uncommon. Therefore, a qualitative study was conducted to assess the perceptions of outpatient breast cancer patients regarding interprofessional collaboration in the breast care unit of an Indonesian referral center hospital. The teamwork involved in the interprofessional collaboration included breast cancer specialists, pharmacists, and nurses. In this study, in-depth interviews were performed with nine breast cancer outpatients. All interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. The findings were divided into two categories to gather breast cancer patients' viewpoints on interprofessional collaboration: (1) obstacle components to interprofessional collaboration: incompleteness of health personnel, no justification from health personnel, no knowledge of patients about health professionals, no involvement of patients in the therapy decision making; (2) enabling elements: patient-oriented, patient expectations, collaboration among healthcare personnel, patient participation in interprofessional collaboration, health personnel responsibilities, comprehensive hospital services. Respondents assumed interprofessional collaboration positively. However, several obstacles must be overcome to implement interprofessional collaboration in a breast care setting effectively. The research findings can be utilized to establish interprofessional collaborations aimed at improving quality healthcare in breast cancer units.

Knowledge and Readiness for Interprofessional Learning Among Pharmacy and Clinical Nutrition Students at King Saud University

Background

Interprofessional education (IPE) in healthcare specialties is important to optimize patient outcomes and shape professional image toward teamwork and collaboration among healthcare professionals. The aim of this study is to assess the impact of IPE on pharmacy and clinical nutrition students’ knowledge in food–drug interactions and readiness for interprofessional learning.

Methods

This pre-post study was conducted at King Saud University between February and March 2020. We held an interprofessional workshop for pharmacy and clinical nutrition students. After we introduced the faculty members who would deliver the food–drug interactions session, the students took a seven-question quiz (total score = 7) to assess their knowledge about the basic concept of food–drug interactions before the session. After that, a 45-minute lecture was provided by a clinical pharmacy faculty member. Students from both disciplines worked on three clinical scenarios. After completing the assigned scenarios, the students retook the quiz to assess their knowledge after the workshop. In addition, student readiness was assessed using the 19-item Readiness for Interprofessional Learning Scale (RIPLS).

Results

A total of 48 students were included in this study. Overall, students’ mean scores in both colleges significantly increased after the workshop (p < 0.01). The mean RIPLS total scores (SD) for pharmacy students and clinical nutrition students were 80.6 (7.48) and 81.26 (6.96), respectively, out of a maximum possible score of 95. These scores indicated positive attitudes toward interprofessional learning in both groups.

Conclusion

Pharmacy and clinical nutrition students’ knowledge regarding food–drug interaction improved after implementing the IPE session. Students also reported higher scores for interprofessional learning. This indicates their willingness to participate in future interprofessional learning activities. Roles and responsibilities domain scores were slightly lower among both groups. Simulation-based activities including profession role exchange can be added to traditional IPE sessions to improve this domain.

Application of Medical-Nursing-Assistance Integration Model Based on Theoretical Basis of Behavioral Psychology in Management of Children’s ICU

The children's intensive care unit is a closed management area with limited visiting time and no accompanying persons. It fails to systematically reflect and summarize the opinions and needs of the families of the children. The more critically ill the family members are, the higher the requirements for medical care. Good relationship between doctors, nurses, assistant, and patients can promote the rehabilitation of children's diseases and achieve the advanced medical model level of “seamless management and no loopholes.” In order to aid the complete intensive care process, it is vital to understand children's psychological and physical development based on children's behavioral psychology when the medical-nursing-assistance (MNA) integration model is used in the children's intensive care unit. Therefore, this paper has completed the following tasks: (1) the development status of the domestic and foreign MNA integration model in the quality management of children's intensive care units is introduced, and the MNA integration model based on the theoretical basis of behavioral psychology is proposed for the following article in children's intensive care. The effect evaluation system of room management provides a theoretical basis. (2) The principle of BP neural network is introduced, and the effect evaluation model of the integrated mode of MNA based on BPNN in the management of children's intensive care unit is constructed. (3) The relevant data collected are used to form an available data set for the model accuracy test. The experimental results show that, after the research in this paper, the BPNN model proposed in this paper is introduced into the MNA integration model to evaluate the effect of the management of children's intensive care units which is practical and effective.

Interprofessional collaboration in the breast cancer unit: how do healthcare workers see it?

BACKGROUND

Interprofessional collaboration has an important role in health care for breast cancer patients who are undergoing treatment at the hospital. Interprofessional collaboration has been reported to provide significant benefits for patients. However, qualitative research on interprofessional collaboration in the breast cancer department is rarely done, therefore, a study was conducted to determine the perception of health practitioners about interprofessional collaboration in the breast care unit at a referral centre hospital in West Java, Indonesia.

METHODS

A qualitative study was carried out using in-depth interviews and focus group discussions (FGDs) with 15 healthcare personnel using total sampling. Participants were chosen among healthcare professionals who treat and in charge for outpatient breast cancer, but were not resident physicians. The FGD approach was used for nurses and pharmacists, and interviews were used for oncologists. The audio recordings of all interviews and FGDs were transcribed verbatim and evaluated using thematic analysis.

RESULT

The findings were categorized into two categories to obtain health care workers' perspectives on interprofessional collaboration: (1) impediment factors: personality, lack of leadership, seniority, healthcare workers with double positions, the need for a clinical meeting, hospital bureaucracy, national health insurance implementation, issues with patients, hospital infrastructure, and evaluation and synchronisation; (2) existing supportive elements: effective cooperation, effective communication, clear job description, interpersonal relationships, Standard Operational Procedure (SOP) for cancer therapy, legality for inter-discipline cancer team, professional responsibility, integrated clinical pathway, patient centred care, and comprehensive health services.

CONCLUSIONS

Interprofessional collaboration was seen positively by the respondents. However, there are several hurdles that must be overcome to apply interprofessional collaboration works effectively. The findings of this study can be used to build interprofessional collaborations targeted at enhancing quality health care in breast cancer units.

Psychometric appraisal of the Readiness for Interprofessional Learning Scale (RIPLS) Arabic-version

Interprofessional education within healthcare has been shown to have many benefits, however, it is a relatively new educational concept within the Arabic setting. Although the Readiness for Interprofessional Learning Scale is a commonly utilised tool to examine student attitudes, there is a lack of evidence for use of an Arabic translated version. The aim of this study was to develop and psychometrically evaluate an Arabic language version of the Readiness for Interprofessional Learning Scale with Saudi nurses. Two independent translators, proficient in both English and Arabic languages, completed a forward-backward translation of the original English version of the Readiness for Interprofessional Learning Scale. Subsequently, this Readiness for Interprofessional Learning Scale-Arabic version was used to collect data from undergraduate nursing students enrolled at a number of Saudi Arabian universities. Exploratory and Confirmatory Factor Analyses were then performed on the scale. Six hundred and fifty-two participants were recruited. Exploratory Factor Analysis of the Readiness for Interprofessional Learning Scale-Arabic version resulted in a 15-item, three-factor model. Subsequent analysis with Confirmatory Factor Analysis and the resultant final 13-item model demonstrated a poor fit between the hypothesized model and the data. Although our three-factor model is supported by previous studies, the proposed model did not perform well on Confirmatory Factor Analysis assessment. This suggests that there may be issues of applicability of the Readiness for Interprofessional Learning Scale-Arabic version within the current cohort. The present study of the Readiness for Interprofessional Learning Scale-Arabic version has demonstrated some psychometric inadequacies and thus it is possible that this scale may not be appropriate for use with Saudi nurses. However further research with different professional groups is suggested to fully explore its utility within the Saudi setting.

Interprofessional Education Competition During the COVID-19 Pandemic at King Saud University: Benefits and Challenges

Background

The objective of this qualitative study was to explore the value of virtual IPE competition that involved a COVID-19 case among healthcare students and the lessons that can be learned to improve this experience in the future.

Methods

The 27 senior students from the colleges of medicine, pharmacy, nursing, and paramedics were invited to two focus groups that followed the IPE competition and lasted 60 minutes each. A semi-structured focus group discussion guide was used in the focus group discussion to explore the benefits and limitations of the virtual IPE experience. Verbatim transcription of the two video-recorded sessions was conducted, and inductive thematic analysis was performed to uncover different emerging themes.

Results

The number of students who consented to participate was 16 (59.26%). The IPE virtual competition was perceived favorably by all students; however, multiple organization and communication barriers were reported. Although the participants liked the IPE virtual competition, they clearly stated their preference for an in-person IPE competition over the virtual one. Managing a COVID-19 case was not perceived favorably by some participants due to the absence of evidence-based clinical guidelines supporting certain treatment protocols over others. Thus, some participants preferred a non-COVID-19 case where clear and evidence-based guidelines exist.

Conclusion

The use of different IPE strategies to enhance healthcare students’ collaboration and understanding of their roles in the multidisciplinary healthcare team, especially during pandemic times, such as COVID-19, is possible. Future studies should examine new and innovative IPE strategies that address the identified limitations of virtual IPE.