Background: Medication error is a global issue that can cause serious harm and even death. Nurses who are responsible for administering medication at the patient interface have the potential to contribute to the problem by making medication administration errors or preventing errors before medication is given. There are multiple contributory factors to the occurrence of error; active failures, local conditions and latent conditions but in order to build a safe culture for patients, it has been recommended that as well as having systems and procedures in place to prevent error, it is important to know the values and beliefs of the staff involved to ensure that they play their part in communicating and preventing errors. In a multi-cultural nursing context such as that in Saudi Arabia the values and beliefs of nursing staff may be different to those in other parts of the world. Aims: The study was designed to explore nurses’ perceptions of medication administration errors in Saudi Arabia. It sought to collect nurses’ views about the factors that may influence medication administration errors, barriers to error reporting and strategies to promote safe medication administration. Methods: A systematic review was undertaken to contextualise the study and identify a gap in the literature. The methodological design adopted for this study is non-experimental, descriptive mixed methods. Quantitative and qualitative components were applied sequentially in two phases. Questionnaires (N=236), and semi structured interviews (N=19) were used to further explain nurses’ perceptions and views on managing medication errors in Saudi Arabia. Results: The systematic review highlighted a lack of in-depth and comprehensive studies of nurses’ perceptions of medication administration errors. This study found that in line with the international literature there are a range of factors that contribute to errors, however, in Saudi Arabia the highest perceived factors were high workload and poor handwriting. There is an underreporting of errors and the fear of the consequences remains the most significant barrier against reporting medication errors. Nurses appear to weigh up the risk to patients before deciding whether to report errors or not. Solutions for minimising errors can be found in a number of strategies at different levels of the organisation; these include staff training and technology solutions such as computer physician order entry (CPOE) or barcode technology. Conclusion: The findings in the current study offer a comprehensive understanding of the views and perceptions of nurses regarding medication errors within the Saudi context. This provides valuable local evidence that can be built into appropriate professional education and procedures for managing medication administration errors for both Saudi and international nurses employed in Saudi Arabian hospitals and thus improve patient safety.

Background: Mental disorder-related stigma, usually experienced through prejudice or discrimination, can gravely impact an individuals’ quality of life. Nurses play an important role in the advocacy and treatment of people with mental disorders. It is therefore important that their attitudes, behaviour and knowledge regarding people with mental disorders are understood within their cultural context and that they are educated appropriately during their early student years. Aim: To develop and evaluate the usability, feasibility and effectiveness of a media-based educational intervention (film) against education as usual practice (lecture), in reducing mental disorder-related stigma in terms of attitudes, knowledge and intended behaviour amongst Saudi nursing students. Methods: The research study draws upon the first two phases (development and feasibility/piloting) of the Medical Research Council’s framework for the development and evaluation of complex interventions. A mixed-methods research design was used, entailing: theoretical and systematic reviews of evidence-based literature; modelling, developing and refining of the intervention-prototype and outcome measures; usability testing with stakeholders; feasibility testing of the refined intervention through an exploratory randomised controlled trial and a qualitative evaluation study to assess the preliminary effectiveness of the intervention. Outcomes were measured at three time points: baseline, immediately post-intervention and at three months follow-up. Results: Outcome measures improved significantly for both intervention conditions in comparison to the control group; however, there was no significant difference in effectiveness between the intervention conditions. The film intervention was more effective in the 3rd-year and the lecture in the 4th-year nursing students. The findings of the qualitative evaluation study showed that student nurses expressed a preference for the inclusion of service users’ personal testimonies in the educational intervention. They were also more likely to remember this component of the intervention than other aspects when in clinical practice. Conclusion: This study contributes to a growing literature supporting the use of filmed social contact interventions containing personal testimonies as an effective educational option to reduce mental disorder-related stigma amongst healthcare students.

Employee engagement is the ability of employees to express themselves ‘physically, cognitively and emotionally during role performance’. Nurse employees comprise the largest workforce in healthcare. They spend a significant time caring for patients, they have a strong impact on patient experiences. Thus, in order to improve patient care experiences, nurse employees require positive work environments with the necessary factors that drive employee engagement. This study aimed to investigate current nurse engagement practices and the work-related aspects that impact engagement among nursing employees. The ultimate goal was to enable nursing management to identify the areas for continued sustainability and to improve gaps identified through appropriate implementation initiatives. The hospital is in the central part of Riyadh, Saudi Arabia, and consists of a multicultural population and the local Saudi nurses. The study population is nursing employees, employed for one year and longer within the organisation, and includes both genders between the ages of 18 to 60 years old. Simple random sampling was adopted using a sampling frame. A structured questionnaire was used to collect data from the sample of nurses from the hospital. Descriptive and inferential statistical tests were performed to analyse data using Statistical Package for Social Sciences (SPSS) version 24 for Windows, while Ordered Probit regression was conducted using the Stata statistical program version 14 for Windows. This study showed the extent of nurses’ engagement using the selected constructs. Areas of strengths and weaknesses were identified. This study found that nurses were generally positive and passionate in their contribution to the organisation and connected in their work roles. This was established statistically and literature was also used to interpret the results. Respondents placed high importance on items that assessed the extent of nurses’ engagement and work-related factors. All the loadings in the eight dimensions measured were above 0.5, which shows significant correlation. In terms of organizational factors that impact nurse engagement, the estimates from the Ordered Probit regression showed that “feelings about the job” by employees had a statistically significant and positive influence on the employees’ or nurses’ “satisfaction about job aspects”. Results suggest the need to strengthen the identified areas in order to improve the nurses’ level of engagement. / Health Studies / M.A. (Nursing Science)