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Background Food and nutritional supplements can interact with medication and cause drug interaction. Registered nurses play an essential role in patients’ safety related to drug interaction. Objective Explore nurses’ knowledge, attitudes, and awareness regarding food–drug interactions (FDIs). Method A cross-sectional survey was conducted among nurses working in the general medical wards at Hamad General Hospital (HGH) in Qatar. The survey questionnaire comprised 50 multiple-choice questions, encompassing three key sections: (a) demographic details, (b) assessment of FDIs knowledge, and (c) exploration of beliefs, attitudes, and practices concerning FDIs. Results A total of 227 surveys were collected. Nurses’ average score for FDI knowledge across all responses was 20 out of 34 (IQR 16–25). Notably, there were no statistically significant differences in average scores based on respondents’ demographic subgroups. While nurses displayed a high level of knowledge (over 90%) regarding the timing of food and drug intake for proton pump inhibitors, nonsteroidal anti-inflammatory drugs, and thyroid hormones, they exhibited limited awareness of the possible FDIs related to carvedilol and furosemide. Approximately half of the participating nurses (56.4%) rated their FDI knowledge as satisfactory. However, only 42.3% claimed to be always educating patients about FDIs in their daily practice. Two-thirds (67.4%) of respondents believed educating patients about FDIs should primarily fall under the responsibility of pharmacists. Conclusion This study highlights the nurses’ knowledge, attitudes, and beliefs of FDIs. Prompt intervention is required to enhance the nurse's awareness and knowledge in this domain which may impact patient care and drug safety.

Background The role of preceptors is vital in the successful integration of new graduate nurses in hospital settings. This study aimed to explore the experiences of nurse preceptors in training newly joined nurses in Qatar. Methods Qualitative study was conducted between May 2022 and May 2023. Online semi-structured interviews were conducted through MS Teams with 13 nurse preceptors who had completed preceptorship training and trained at least one newly joined nurse. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis. Results The results of the study revealed several main themes: teaching strategies and progressive skill development in preceptorship, challenges faced by the preceptor and preceptor better supported in training new nurses. The preceptors utilized different techniques to support new nurses including demonstration, discussion, use of technology, application of real-life clinical scenarios, simulations, and a gradual decrease in supervision to promote independence. However, a significant challenge was also reported including preceptors experienced high levels of exhaustion from the dual responsibilities of training new staff while also performing their regular care duties. Conclusions The study underscores the fundamental role preceptors play in the training and development of newly joined nurses. While the challenges are considerable, particularly related to managing workload, the sense of achievement following the successful completion of training a new nurse suggests a strong commitment to this role. Despite the challenges, preceptors demonstrated innovative strategies to ensure the successful development of their preceptees, highlighting the importance of preceptorship in nursing education and practice.

Background The use of 12-h shifts for nursing staff has become common in many healthcare settings, including tertiary hospitals, due to its potential benefits such as reduced handover time and increased continuity of care. However, there is limited research on the experiences of nurses working 12-h shifts, particularly in the context of Qatar, where the healthcare system and nursing workforce may have unique characteristics and challenges. This study aimed to explore the experiences of nurses working 12-h shifts in a tertiary hospital in Qatar, including their perceptions of physical health, fatigue, stress, job satisfaction, service quality, and patient safety. Methods A mixed method study design was applied consisting of a survey and semi-structured interviews. Data was collected from 350 nurses through an online survey and from 11 nurses through semi-structured interviews. Data was analyzed using Shapiro–Wilk test and the difference between demographic variables and scores were examined using Whitney U test and Kruskal- Wallis test. Thematic analysis was used for qualitative interviews. Results The results from quantitative study revealed nurses perception in working 12-h shift has negative impact in their wellbeing, satisfaction as well as patient care outcomes. Thematic analysis revealed real stress and burnout and experienced an enormous amount of pressure going for work. Conclusions Our study provides an understanding of the nurse’s experience working 12-h shift in a tertiary level hospital in Qatar. A mixed method approach informed us that, nurses are not satisfied with the 12-h shift and interviews revealed high level of stress and burnout among nurses resulting in job dissatisfaction and negative health concerns. Nurses also reported that it is challenging to stay productive and focused throughout their new shift pattern.

BackgroundShortening the patient experience time (PET) in the emergency department (ED) improves patient quality and satisfaction and reduces mortality and morbidity. Worldwide, the PET target in the ED is ≤ 6 hours; however, the PET awaiting admission to inpatient Medicine at Hamad General Hospital (HGH) in the Qatar State, through ED is currently 15.3±6.4 (mean ± SD) hours.AimIdentify solutions to reduce the PET duration at HGH-ED to the international target.MethodA cohort study was done using the Discrete-event simulation (DES) model, utilizing a commercial simulation software package (Process Model Inc., Utah, version 5.2.0). One-year data, January 1, 2019 - December 30, 2019, was analyzed and found to follow seven subprocesses. The duration of each subprocess was recorded, and the average time was calculated. A computer simulation scheme was developed for all the subprocesses of the actual PET duration. The simulated PET was validated, and scenarios were proposed and assessed for each subprocess separately and in combination,A constructed simulatory design using an iterative process involving a construction model. This model starts with the logical organization of submitted tasks based on their cycle times. A subject-matter expert interview was conducted to determine the appropriateness and frequency of actions. The duration of each activity in the considered process was defined using a triangular distribution.ResultsThe actual PET duration for the Medical Department was 15.3±6.4 (mean + SD) hours. The three most prolonged PET subprocess durations were in the referral to internal medicine, the decision to admit, and finding a free bed; these represent 17.9%, 53.8%, and 16.7% of the PET, respectively. Adding two physicians to each shift, which shortens the subprocess of the decision to admit, reduced the PET duration by 27.5%. Moreover, creating a new admitting team (unit) that takes care of new patients admitted to the ED reduced PET duration by another 12.5%. Combining these two scenarios reduced the average PET duration to only 10.2±0.5 hours. In addition to these scenarios, the PET can be further decreased to six hours by increasing the number of inpatient beds.ConclusionsThe simulated scenarios indicated that restructuring the medical teams, adding two physicians to each shift, and creating an admissions team dedicated to the ED would reduce the total PET duration to 10.2 hours, Furthermore, PET's further reduction to six hours is predictable by increasing the bed number.

Purpose Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as critical. Much patient experience research is quantitative and survey based. The purpose of this paper is to report a qualitative study gathering in-depth data in an emergency department (ED). Design/methodology/approach The authors used empirical data from seven focus groups to understand patient experience as participants progressed through a major teaching hospital in an Ireland ED. A convenience sampling technique was used, and 42 participants were invited to share their perceptions and outline key factors affecting their journey. A role-playing exercise was used to develop improvement themes. Data were analysed using thematic analysis and data analysis software (NVivo 10). Findings Capturing ED patient experience increases our understanding and process impact on the patient journey. Factors identified include information, access, assurance, responsiveness and empathy, reliability and tangibles such as surroundings, food and seating. Research limitations/implications Owing to the ED patient’s emergency nature, participants were recruited if triaged at levels 3–5 (Manchester Triage System). The study explored patients’ immediate rather than post hoc experiences where recollections may change over time. Originality/value To the authors’ knowledge, no study has examined in-depth, ED patient experience in Ireland using qualitative interviewing, obtaining critical process insights as it occurs. The potential to inform patient process improvements in Irish EDs is significant.

BackgroundRoot cause analysis (RCA) can be threatening and intimidating to staff nurses.180% of nurses perceived being blamed and had a negative psychological impact following the RCA but often cannot find any support emotionally and psychologically (figure 1).2 3 The first department based second-victim support program ‘Talk to Me’ provided an effective person-centred emotional and psychological first aid for the staff nurses who self-identified as second-victims.1–3 The project is aimed to increase the access to support programs for self-identified second-victims among nurses from February 2021 to February 2023 in the Medical Department.MethodsThe ‘Talk to Me’ Program was started November 2021 with an awareness campaign. Awareness classes regarding second-victim phenomenon and the referral pathway was presented to the nurses of the pilot units. It can be accessed by nurses through the following three mechanisms: Direct contact with peer supporters, utilization of the 24/7 hotline, and referral from direct line managers. The peer supporters were Compassionate Health Interaction (CHI)-trained nurses who can host any uncomfortable conversations. After 48 hours, nurses were followed up with by the peer supporter and a survey was given to assess their responses to the session.ResultsIn a span of 2 years, a total of 11 nurses approached the support sessions and 100% of them had a highly favorable response towards the support group. The majority of reasons were related to medical errors and 100% of these nurses are highly satisfied with their ‘Talk to Me’ experience relative to empathy, empowerment, and equity (figure 2).ConclusionThe ‘Talk to Me’ support program adopted a person-centred care approach that cultivated empathy, empowerment, and equity for nurses. Provision of the simplest emotional support ranging from peer interactions to professional support is critical for nurses’ psychosocial recovery after any safety event.Abstract 17 Figure 1Reasons of lack of support for second-victims[Figure omitted. See PDF]Abstract 17 Figure 2Nurse’s experience with second-victim support program (empathy, empowerment and equity)[Figure omitted. See PDF]ReferencesScott, SD. Second victim support: Implications for patient safety attitudes and perceptions. PSQH [Online]. 2015. Retrieved 22 May 2024 from: https://www.psqh.com/analysis/second-victim-support-implications-for-patient-safety-attitudes-and-perceptions/Scott, S. (2016). Care at the point of impact: Insights into the second-victim experience. J Healthc Risk Manag. 2016;35(4):6–13. Doi: 10.1002/jhrm.21218The Joint Commission. Supporting second-victims. Quick Safety- JCI. Division of Healthcare Improvement 2018;39:1–3. Retrieved 22 May 2024 from:https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-39-supporting-second-victims/Ethical Approval/IRB StatementThis quality improvement project was granted approval from the Executive Nursing Leadership of Hamad General Hospital (HGH) in December 2021.Disclosures and AcknowledgmentsThe authors of the project would like to acknowledge the leaders, supervisors, and patients who were involved in the conceptualization of the project.

Background‘Leanomics’, a term first conceptualised in Hamad General Hospital (HGH), addresses the positive financial implications of using lean tools in healthcare.1 The three-year implementation of the Doha-based innovation called the ‘Modified Kanban System (MKS)’1–3 helped the leaders, and the front-liners establish a standardised process to reduce costs and waste in the storerooms, which were identified opportunities for improvement. The project was aimed to reduce the cost by 50% (from QAR 16,000 to 8,000 per unit) for three years in HGH storerooms (June 2020 to June 2023).MethodsDifferent lean methods with the Kanban system were introduced using the Institute for Healthcare Improvement Model for Improvement, and in 2020, the change idea was tested in one unit. Several Plan-Do-Study-Act cycles were also tested and implemented such as categorising consumables as fast or slow-moving items, implementing bin systems for fast-moving items, and standardising consumable quantity. The MKS was adopted to additional units in 2021 (scale up), and with the support and engagement of the various department leaders, it has a full spread in 2022.ResultsA significant 65% cost reduction resulted in monthly savings of QAR 8,000 -10,000 (per unit) (figure 1), with an anticipated annual saving of QAR 2.5 million, where for every 1% cost reduction a QAR 3,000 is saved. Out-stocking rate of consumables was also reduced from 5–30 to 0–3 out-stocking per 1,000 patient days (figure 2). Through strong leadership engagement, 16 units were kanbanized across HGH in different specialties.ConclusionLeadership engagement is a critical factor in sustaining a stable lean culture. The MKS, as an innovative example of ‘Leanomics’, is not only an effective cost-reduction strategy, but also an important patient and staff experience tool ensuring the delivery of the right consumables in the right quantity at the right time, the most cost-effective way possible.Abstract 16 Figure 1Average costs in Qatar riyals control chart (x bar-chart)[Figure omitted. See PDF]Abstract 16 Figure 2Out-stocking per 1,000 patient days control chart (u-chart)[Figure omitted. See PDF]ReferencesLogrono KJ, Zu’Bi BS. Reduction of wastes and costs through the modified kanban system in unit storerooms of hgh: a value-for-money quality improvement initiative. Research Square; 2021. DOI: 10.21203/rs.3.rs-1070569/v2.Escobar VG, Bourque S, Godino-Gallego N. Hospital Kanban system implementation: evaluating satisfaction of nursing personnel. Science Direct Journal 2015;21(3):101–110. Retrieved from https://doi.org/10.1016/j.iedee.2014.12.001Landry S, Blouin JP, and Beaulieu M. (2013). The challenges of hospital supply chain management from central stores to nursing units. B.T. Denton (Ed.), Handbook of healthcare operations management: Methods and applications, 184, Springer Science Business Media, New York, pp. 465–482Ethical Approval/IRB StatementThis quality improvement project was granted approval from the Executive Nursing Leadership of Hamad General Hospital (HGH) in May 2020.Disclosures and AcknowledgementsThe authors of the project would like to acknowledge the leaders, supervisors, and patients who were involved in the conceptualisation of the project.

BackgroundEnhanced recovery after surgery (ERAS) is a multimodal approach to perioperative care that maintains adequate pre- and post-operative well-being following Video-Assisted Thoracoscopy Surgery (VATS).1 2 The reasons why VATS patients had a prolonged hospital length of stay (LoS) were found to be inadequate lung expansion, lack of drainage on chest tubes, and unanticipated leaking, which resulted in 10–20% increase in LoS. The project aimed to reduce patient LoS by 30% (from 9 days to 6.3 days) over the end of one year (Dec 2022–Jan 2023).MethodsThe Institute for Healthcare Improvement (IHI) Collaborative Model for Improvement was used as a Quality Improvement (QI) approach and different evidence-based practices were tested to come up with the core elements of the Physiokinesis Program.1–3 These included special arm exercises (usually on the operative side), 1 2 proper use of incentive spirometry (IS), deep breathing exercises (DBE), early ambulation, personalized pre-operative teaching,3 and psychological orientation of what to expect post-VATS.3Upon admission, the patient is immediately assessed by physicians and a Physiotherapy (PT) referral is ordered; other components of the Physiokinesis Program are completed by nurses and the physiotherapist. Run and control charts were used to determine if significant shifts occurred in the measures over time.ResultsA total of 68 VATS patients were enrolled in the Physiokinesis Program. There was a 56% reduction of LoS (from 9 days to 4 days) for enrolled patients (figure 1), and post-procedure complication rates reduced significantly by 50% (from 2–4 to 0–1 complications per 1,000 patient days) (figure 2).ConclusionThe novel interventions under the Physiokinesis Program were person-centered approaches that effectively reduced patients’ LoS and enhanced their post-surgery recovery. Compliance with Physiokinesis Programs‘ components improved patient outcomes, resulting in 100% of patients responding favourably and ensuring a 100% safe discharge with 0% unplanned readmissions.Abstract 15 Figure 1Average length of stay (LoS) control chart (in days) of video-assisted thoracoscopy surgery patients[Figure omitted. See PDF]Abstract 15 Figure 2Post-procedure complications per 1,000 patient days control chart[Figure omitted. See PDF]ReferencesBertani A, Ferrari P, Terzo D, Russo E, Burgio G, De Monte L, Raffaele F, Droghetti A, Crisci R. A comprehensive protocol for physiokinesis therapy and enhanced recovery after surgery in patients undergoing video-assisted thoracoscopic surgery lobectomy. Journal of Thoracic Disease 2018;10(Suppl 4):S499–S511. https://doi.org/10.21037/jtd.2018.02.55Akezaki Y, Nakata E, Tominaga R, Iwata O, Kawakami J, Tsuji T, Ueno T, Yamashita M, Sugihara S. Short-term impact of video-assisted thoracoscopic surgery on lung function, physical function, and quality of life. Healthcare 2021;9(2):136. https://doi.org/10.3390/healthcare9020136Bazezew A, Nuru N, Demssie T. et al. Knowledge, practice, and associated factors of preoperative patient teaching among surgical unit nurses, at Northwest Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, BMC Nurs 2022;22:20 (2023). https://doi.org/10.1186/s12912-023-01175-2Ethical Approval/IRB StatementThis quality improvement project was granted approval from the Executive Nursing Leadership from the Hamad General Hospital (HGH) in December 2022.Disclosures and AcknowledgmentsThe authors of the project would like to acknowledge the leaders, supervisors, and patients who were involved in the conceptualization of the project.