Average length of patient stay in inpatient and the emergency room Hiba Chagla, Abbas Al Mutair Saudi Critical Care Journal 2019 3(2):73-74

Exploring acute care workplace experiences of Saudi female nurses: Creating career identity Sharifah Alsayed, Sandra West Saudi Critical Care Journal 2019 3(2):75-84 Background: Saudi registered nurses (RNs) currently comprise 30% of Saudi Arabia's nursing workforce, and turnover/attrition rates remain problematic. No studies exploring Saudi RNs' experiences of acute care work and/or the factors that influence their decision to continue working were located. Purpose: To construct an insightful understanding of the acute care workplace experiences of female Saudi RNs and factors affecting retention. Methods: Snowball sampling was used to recruit 26 female acute care Saudi RNs who were interviewed about their workplace experiences. A constructivist grounded theory approach was used to code and categorize data to construct a shared understanding reflective of the experiences of participants and the researcher as both constructing the meanings given. Results: Shared understandings of patients' culture, religion, and language were assisting Saudi RNs to feel competent in making a unique contribution to patient care. Although participants reported negative impacts from some workplace policies, they were able to create their own identity and to find their own place by creating a career identity as Saudi-Muslim nurses. Successfully creating this unique nursing identity enhanced their motivation, work commitment, and competence; however, difficulties were encountered in accommodating work conditions and working as a minority group within a workplace largely staffed by foreign nurses. Conclusion: Saudi nurses' acute care workplace experiences were found to be complex and challenging and significantly affected by the lack of supportive policies designed to help them to keep working clinically. Implications for Nursing Policy: Workplace retention of Saudi RNs is an organizational issue that needs wide discussion to enable continuing clinical work of Saudi female nurses.

Emergency medical service providers' knowledge and perception of sepsis at Makkah Saudi Red Crescent Authority Bassam Hassan Basaffar, Nasser Safar Aloitibi, Rashed Mohammad Alzahrani, Omar Osama Felimban, Khalid Safir Algethami, Abdullah Hamdan Alshehri Saudi Critical Care Journal 2019 3(2):85-91 Background: Sepsis is a life-threatening condition existing worldwide and is frequently known as the “hidden killer” because it is a time-sensitive illness, like myocardial infarction and cardiac arrest; therefore, prehospital providers must have adequate knowledge about it. Aim: The aim was to measure the knowledge and perception of sepsis among emergency medical service (EMS) providers to assure better patient prognosis. Methodology: A cross-sectional paper-based questionnaire survey comprising 15 questions, divided into three sections, was conducted at Makkah Saudi Red Crescent Authority to evaluate their knowledge related to the signs and symptoms of sepsis in particular and management and perception of sepsis in general. The responses received were categorized according to the specialties considering P < 0.05 as statistically significant. Results: The total number of study participants was 102; 26 participants were excluded because they did not meet the inclusion criteria. Among the remaining 76 participants, 64.5% were technicians and 35.5% were specialists. The most common age group was 25 ± 5 years which composed 46.1% of the total participants, and the highest years of experience was between 6 and 10 years which composed 47.4% of the total participants. According to a 5-point Likert scale, there was an adequate level of EMS provider perception on the knowledge of sepsis. Nearly 55.6% of the specialists knew the three stages of sepsis better than technicians (40.8%). Both the technicians and specialists had poor knowledge regarding hypothermia (technicians 20.4% and specialists 25.9%) as a sign of sepsis, in addition to administering intravenous antibiotics (technicians 28.6% and specialists 14.8%) as a management modality. On the other hand, both had enough knowledge regarding the other signs and symptoms with an average of 72.8% and the management of sepsis with an average of 72%. Conclusion: Overall, all participants had a good level of knowledge related to sepsis. However, the participants lack knowledge on administering antibiotics and hypothermia; moreover, their attitude and willingness toward recognizing and managing septic patients is unknown. Hence, it is recommended that further research may be undertaken to measure it at a larger scale and efforts be made to educate the providers certainly on the knowledge they lack of.

Hairpin coiling of central line catheter: Pinch-off syndrome? Ravneet Kaur Gill, Uma Rathi, Charmila Choudhary, Aravind B Guledagudd Saudi Critical Care Journal 2019 3(2):92-94 Central line insertion is a commonly performed procedure in the intensive care unit. Although technical difficulty is moderate, experience decreases the failure rate. Central vein catheter (CVC) insertion is associated with various complications such as pneumothorax and arterial puncture, but rare possibilities such as coiling of catheter can still occur and every intensivist should be cautious about it. Chest X-ray remains the gold standard to confirm the course and position of CVC and should be correlated with clinical findings. We report a case where CVC insertion was associated with coiling and led to occlusion of the proximal port.