Issa M. Hweidi

Laboratory confirmed health care-associated bloodstream infections: A Jordanian study

BACKGROUND Few studies have been conducted in Jordan related to health care associated bloodstream infections (HCABSIs). This study aims to examine epidemiology of HCABSIs among hospitalized adult patients in Jordan. METHODS A cohort study (N=570; 445 confirmed HCABSIs, 125 uninfected patients) with a nested 1:1 matched case-control design (n=125 in each group) was used based on data from one large referral hospital in Jordan over a period of 5 years. HCABSI cases were determined based on confirmed positive blood culture after 48h of admission. The case-control analyses (n=250 per group) matched on gender, age, same admission month and unit. RESULTS The overall incidence and mortality rates were 8.1 and 5.8 per 1000 admissions, respectively. Four-variable and three-variable multivariate models were proposed to explain the risk of HCABSIs in the matched analyses .The four-variable model consists of blood product (OR=24.5), invasive procedures (OR=4.3), renal failure (OR=9.2), and presence of other infections (OR=21.6). The three-variable model consists of recipient of blood product (OR=19.7), invasive procedures (OR=4.5), and renal failure (OR=9.4). CONCLUSIONS This study is a pioneer study that examined risk factors, the associated HCABSIs in Jordan. Results from this study can be used to influence infection control plans in Jordan.

Jordanian parental needs of critically ill infants in neonatal intensive care units

This descriptive correlational study was conducted to identify perceived parental needs of critically ill infants in Neonatal Intensive Care Units (NICUs). Jordanian parents who were visiting their infants admitted in NICU (N = 170) composed the study sample. Participants completed the demographic data sheet and the NICU Family Needs Inventory. Findings showed that parents ranked assurance, information and proximity as the most important needs, while comfort and support were ranked the lowest. The primary concern of parents was to be assured and informed about the progress of their infant. In addition, the results indicated that the mother’s perceived needs for support, information and proximity were significantly more important than the fathers. Accordingly, nurses should establish a rapport with family members and provide them with understandable and honest information. Furthermore, the provision of quality, holistic, family-centered nursing care that relies primarily on early and comprehensive needs assessment, which correlates with infants’ outcomes, is imperative.

Prevalence of depression and its associated factors in patients post-coronary artery bypass graft surgery:

This research aimed to determine the depression level and its correlation experienced by post-coronary artery bypass graft patients after being discharged from cardiac intensive care units. A cross-sectional design was employed for assessing variables. The Self-rating Depression Scale, as proposed by Zung, was used by the researchers on a convenience sample of Jordanian patients (N = 143) who were approached soon after their discharge from the targeted units. The results suggested that the level of depression among Jordanian patients was relatively high (M = 62.7, SD = 5.6). Moreover, depression was significantly higher among female, unmarried and unemployed patients. Patients who received their information about coronary artery bypass graft surgery from nurses had a lower level of depression. Age, length of stay in the cardiac intensive care unit and hospital type significantly predicted the level of depression. The research concluded that the post-coronary artery bypass graft patients who experienced an early onset depression required more attention to highlight the importance of supportive interventions.

Reality of obesity paradox: Results of percutaneous coronary intervention in Middle Eastern patients

Objective The aim of this study was to assess the baseline clinical characteristics, coronary angiographic features, and adverse cardiovascular events during hospitalization and at 1 year of follow-up in obese patients compared with overweight and normal/underweight patients. Methods A prospective, multicenter study of consecutive patients undergoing percutaneous coronary intervention was performed. Results Of 2425 enrolled patients, 699 (28.8%) were obese, 1178 (48.6%) were overweight, and 548 (22.6%) were normal/underweight. Obese patients were more likely to be female and to have a higher prevalence of diabetes, hypertension, hypercholesterolemia, or previous percutaneous coronary intervention. Acute coronary syndrome was the indication for percutaneous coronary intervention in 77.0% of obese, 76.4% of overweight, and 77.4% of normal/underweight patients. No significant differences in the prevalence of multi-vessel coronary artery disease or multi-vessel percutaneous coronary intervention were found among the three groups. Additionally, no significant differences were found in stent thrombosis, readmission bleeding rates, or cardiac mortality among the three groups during hospitalization, at 1 month, and at 1 year. Conclusion The major adverse cardiovascular event rate was the same among the three groups throughout the study period. Accordingly, body mass index is considered a weak risk factor for cardiovascular comorbidities in Arab Jordanian patients.

Research Use of Nurses Working in the Critical Care Units: Barriers and Facilitators

Background: There is a distinct gap between theory and practice with respect to research use in clinical practice, particularly in critical care units, that could be related to the presence of a number of barriers that hinder the use of research findings. Aims: The aims of the study were to identify barriers and facilitators to research use as perceived by Jordanian nurses in critical care units and to examine the predictors of research use among those nurses. Methods: The study used a cross-sectional, correlational design. The self-administered “Barriers Scale” was introduced to 200 registered critical care nurses, using the drop-and-collect technique, between October and November 2015. Results: The results revealed that “nurse does not have time to read research at work” was the top ranked barrier that hinders research use (mean [SD], 3.45 [0.79]). The first 7 ranked barriers were related to the organizational subscale. Managerial support was the top perceived facilitator for research use. Only “attending special training courses in nursing research” was the significant predictor of research use and explained 59.1% of the variance in research use, t(190) = −3.93, P = .003. The most identified barriers toward research use revealed by the qualitative data include dominant routine nursing tasks, existence of gap between theory and practice, shortage of nursing staff, and public negative image about nursing profession. Participants suggested the importance of increasing organizational support and creating an organizational research culture to further promote research use in clinical nursing practice. Conclusions: Research use has not been widely implemented yet in Jordan because of various barriers. The organization-related barriers were the most influential. Factors hindering research use are multidimensional, and optimizing them should be a shared responsibility of nurse managers, researchers, clinicians, and academicians. Further initiatives are required to raise awareness of the importance of using evidence-based practice.

Attitudes and perception of baccalaureate nursing students toward educational simulation

Abstract Background: Simulation can produce highly qualified professionals, however, it can also be perceived as stressful and frustrating by the nursing students. Purposes: This study was to identify the attitudes and perceptions of Jordanian nursing students toward simulation as an educational strategy, to investigate whether certain students’ characteristics affect their attitudes and perceptions, to assess for differences in the attitudes and perceptions toward simulation between the different year levels of students, and to identify the important predictors of students’ attitudes and perceptions toward educational simulation. Method: A descriptive correlational design was used with a convenience sample of 413 Jordanian nursing students. The Arabic translated version of KidSIM ATTITUDES scale was used. Results: The total attitude score was encouraging with significant differences between first, second and third year students. Post hoc analyses showed the lowest attitude mean score occurring in the second year nursing students. Using linear regression analysis, prior experience in an ICU or CCU was the only significant predictor of the student’s attitudes and perceptions toward simulation. Conclusions and implication for practice: Reinforcing the teamwork approach during the students’ early phases of their course of study, and incorporating simulation into later phases can promote knowledge development, skill acquisition, and self-confidence.