Background: Cultural competence is increasingly recognized as a vital component of nursing practice, particularly in multicultural healthcare environments such as Saudi Arabia, where expatriates comprise the majority of the nursing workforce. Objective: To examine the relationship between nurses’ cultural competence and their perceptions of patient-centered care in a tertiary hospital in Riyadh. Methods: A descriptive correlational design was employed. A total of 166 nurses were surveyed using the Nurse Cultural Competence Scale (NCCS) and the Individualized Care Scale–Nurse (ICS-Nurse). Data were analyzed using descriptive statistics, chi-square tests, and Pearson correlation. Results: Nurses demonstrated moderate cultural competence (mean = 2.85, SD = 1.09) and high perceptions of patient-centered care (mean = 3.96, SD = 0.86). A weak positive correlation was observed between cultural competence and patient-centered care (r = 0.1285, p = 0.099). Nationality significantly influenced both cultural competence (χ² = 64.750, p < 0.001) and patient-centered care perceptions (χ² = 69.935, p < 0.001), while sex, educational attainment, and years of expertise showed no significant associations. Conclusion: Cultural competence modestly influences nurses’ perceptions of patient-centered care. Ongoing training programs and organizational policies that emphasize cultural awareness and communication are essential to enhance care quality in diverse healthcare settings.

Background: Burnout is a significant occupational phenomenon, particularly prevalent among healthcare professionals due to the demanding and emotionally taxing nature of their work. The World Health Organization (2019) officially recognized burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed. It is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment (Maslach & Jackson, 1981). In the Kingdom of Saudi Arabia, studies have indicated alarmingly high levels of burnout among nurses across various clinical settings. A study by Alenezi et al., (2019) found that approximately 62% of nurses in Saudi hospitals experience moderate to high levels of burnout. This issue is particularly concerning in pediatric and maternity settings, where emotional demands are intensified by the vulnerability of the patient population and the expectations of families. Several factors have been identified as contributing to nurse burnout in these settings, including long working hours, staff shortages, high patient loads, shift work, and inadequate managerial or emotional support (Al-Turki et al., 2010; Chemali et al., 2019). These pressures are often exacerbated during the winter season, which is associated with higher pediatric admission rates due to seasonal illnesses, resulting in increased stress and workload for nurses (Almutairi et al., 2021). Objective: This study aims to assess the prevalence of burnout among pediatric nurses working in Maternity and Children Hospital in Dammam during the winter season. It also seeks to identify the main risk factors contributing to burnout and to explore the coping strategies used by nurses. Methods: A cross-sectional study was conducted using a self-administered questionnaire based on the Copenhagen Burnout Inventory (CBI). Which defined as a free and validated tool developed to measure burnout in different domains of life particularly among healthcare workers (Kristensen et al., 2005). The CBI consists of three sub-scales: personal burnout, work-related burnout, and patient-related burnout. The survey was distributed to approximately 80 pediatric nurses working in the Pediatric Emergency Room (PER) and Pediatric Medical Ward at a Maternity and Children Hospital. The sample size was calculated using Slovin’s formula to ensure adequate representation. Data were analyzed using descriptive and inferential statistics to assess burnout levels and identify associated risk factors. Results: The findings indicated high levels of burnout among pediatric nurses across all three CBI domains. The highest scores were observed in the work-related and patientrelated burnout sub-scales, reflecting the demanding nature of pediatric care. The most prominent contributing factors were excessive workload and insufficient managerial support. Nurses reported several coping mechanisms, including peer support, relaxation and mindfulness techniques, and the expressed need for more qualified pediatric staff to distribute the workload more evenly. Conclusion: Burnout among pediatric nurses in this hospital is alarmingly high, particularly during the winter season. Addressing key risk factors and enhancing coping strategies is essential to improving nurse well-being and ensuring high-quality patient care.

Background: Neonatal morbidity and mortality remain critical public health challenges in low- and middle-income countries. Neonatal Intensive Care Units (NICUs) play an essential role in improving neonatal survival. Understanding admission patterns and clinical outcomes is vital for clinical auditing, resource allocation, and optimizing perinatal care protocols. Objective: To evaluate the patterns, clinical indications, maternal-neonatal determinants, and outcomes of neonates admitted to the NICU at Omdurman Maternity Hospital, Sudan. Methods: A hospital-based descriptive analytical cross-sectional study was conducted between October 20 and December 20, 2025. A consecutive sample of 50 neonates admitted to the NICU was enrolled. Maternal, neonatal, clinical, and therapeutic data were extracted retrospectively from medical records using a structured data collection instrument. Statistical analyses were performed using SPSS version 27.0, applying descriptive metrics and Chi-square / Fisher's exact tests to examine associations between delivery mode and clinical outcomes. Results: Most mothers were aged 25–30 years (46.0%), with 86.0% attending antenatal care. Emergency cesarean section was the primary mode of delivery (52.0%). Preterm neonates (<37 weeks) accounted for 60.0% of admissions, and low birth weight (<2500 g) constituted 84.0% (LBW: 44.0%, VLBW: 32.0%, ELBW: 8.0%). Neonatal resuscitation at birth was required in 72.0% of cases. The predominant indication for admission was respiratory distress syndrome (RDS) (74.0%), followed by suspected neonatal sepsis (18.0%). During hospitalization, acquired sepsis occurred in 28.0%, and 50.0% had a hospital stay exceeding 7 days. Overall in-hospital mortality was 2.0% (n=1), with 56.0% discharged either fully recovered or clinically improved. Mode of delivery was significantly associated with hospital-acquired sepsis (p = 0.002), but not with length of stay (p = 0.233) or final disposition (p = 0.367). Conclusion: Prematurity, low birth weight, and RDS represent the primary burden of NICU admissions in this setting. Enhancing intrapartum monitoring, universal access to continuous positive airway pressure (CPAP), and rigorous infection prevention programs are crucial to improving neonatal outcomes in resource-limited tertiary centers.

Background: Intimate partner violence (IPV) may adversely affect the wellbeing, treatment adherence and engagement in care of women living with HIV. This study determined the prevalence, patterns and factors associated with IPV among women receiving HIV care in North-Central Nigeria. Methods: A hospital-based cross-sectional study was conducted among women living with HIV attending the Federal University Teaching Hospital, Lafia. Following data cleaning, 296 eligible unique participants were retained. IPV was assessed using the eight-item Women Abuse Screening Tool (WAST); scores ≥5 indicated probable IPV during the preceding 12 months. Descriptive statistics, chi-square or exact tests and multivariable logistic regression were employed. Results: Among 288 participants with complete WAST responses, 151 screened positive for IPV, giving a prevalence of 52.4%. Emotional, physical and sexual abuse were reported by 44.1%, 42.4% and 22.9%, respectively. In the adjusted model (n=268), women aged 25–34 years had higher odds of IPV than those aged 35–44 years (AOR=3.92; 95% CI: 1.22–12.61), whereas women aged ≥55 years had lower odds (AOR=0.20; 95% CI: 0.07–0.63). Remaining with the same partner since HIV diagnosis was associated with increased odds of IPV (AOR=4.65; 95% CI: 1.50–14.37). The model demonstrated acceptable calibration and discrimination. Conclusion: IPV was common among women receiving HIV care, with emotional and physical abuse particularly prominent. HIV services should incorporate confidential, trauma-informed enquiry, safety assessment and appropriate multidisciplinary referral pathways.

Background: Effective infection control in operation theatres (OTs) depends heavily on nurses' knowledge of, and adherence to, aseptic techniques. At Hospital Queen Elizabeth II (QEH II), Sabah, internal audits documented a rise in OT nosocomial infection rates from 4.0% in 2020 to 5.1% in 2023, alongside a hand hygiene compliance rate of only 70%, raising concern about the adequacy of current infection control practice. Objective: This study evaluated the level of knowledge and practice of aseptic techniques among nurses working in the OTs of QEH II and examined the relationship between these two variables. Methods: A quantitative, cross-sectional design was employed. Using Krejcie and Morgan's (1970) formula applied to a population of 180 OT nurses, a stratified random sample of 95 respondents was proportionally recruited across the morning, afternoon, and night shifts. Knowledge was measured with a 20-item multiple-choice instrument adapted from the Aseptic Techniques Knowledge Scale (Lee, 2017; Cronbach's α = 0.85), and practice was measured with a 20-item, 3-point Likert-scale instrument adapted from the Aseptic Technique Compliance scale (Smith, 2019; Cronbach's α = 0.82). Data were analysed descriptively (frequency, percentage, mean, standard deviation) and inferentially using the chi-square test of independence, following confirmation of non-normal distribution via the Shapiro-Wilk test. Results: Nearly half of the participants (49.5%; mean = 14.25, SD = 1.75) demonstrated moderate knowledge, while 30.5% showed low knowledge and 20.0% showed high knowledge. For practice, 55.8% (mean = 20.75, SD = 3.15) demonstrated moderate adherence, 25.3% demonstrated poor adherence, and 18.9% demonstrated good adherence. A chi-square test of independence revealed a statistically significant association between knowledge and practice levels, χ² (4, N = 95) = 42.67, p < .001. Conclusion: Knowledge and practice of aseptic techniques among OT nurses at QEH II were predominantly moderate, and higher knowledge was significantly associated with better practice. However, systemic barriers, including workload pressure, staffing shortages, and inconsistent resource supply, appeared to constrain the translation of knowledge into consistent practice. Targeted competency-based education, simulation-based training, and organisational-level investment in staffing and supplies are recommended to close the knowledge-practice gap and reduce nosocomial infection risk in surgical settings.

Background: Emergency department (ED) quality indicators monitor timeliness, safety, effectiveness, patient flow, and patient-centered care. Several indicators also signal the performance of patient-flow logistics, including queueing, throughput, handoffs, and coordination of time-critical resources. Nurses influence these processes, yet their familiarity with formal measurement frameworks may vary. Aim: To assess ED nurses' self-reported awareness of selected clinical quality indicators, examine its association with ED experience, and interpret the measured flow- and timeliness-related indicators from a healthcare-logistics perspective. Methods: A cross-sectional survey was completed by 45 ED nurses. Ten indicators were rated on a five-point self-reported awareness scale and grouped into four domains. Internal consistency was assessed using Cronbach's alpha. Descriptive statistics, exploratory contingency-table analyses, and Spearman correlation were reported. Healthcare logistics was an interpretive framework rather than a directly measured construct; the instrument did not assess procurement, inventory, replenishment, internal transport, or supply-chain performance. Sparse cells and multiple item-level tests required cautious inference. Results: The awareness scale showed good internal consistency (Cronbach's alpha = .89). Longer ED experience was positively correlated with the overall awareness score (Spearman's rho = .374, p = .011; N = 45). The reported omnibus association between experience group and categorized overall awareness was significant (chi-square (6) = 23.104, p = .001), although sparse expected counts limit conventional chi-square inference. Of the flow- and timeliness-related item tests, only door-to-doctor/ECG time met a conservative Bonferroni benchmark of .005. Clinical experience was the most frequently reported information source. Conclusion: Longer ED experience was associated with greater self-reported awareness. The findings support integrating patient-flow logistics into nursing orientation and quality-improvement training, but they do not provide evidence about supply-chain performance. The small sample, self-report measure, sparse cells, and cross-sectional design restrict causal and generalizable conclusions.

Background: Inadvertent medication administration errors and secondary contamination during pediatric pharmaceutical preparation represent critical global patient safety threats. Direct bedside observation provides an authentic clinical audit of actual nursing practice compared with self-reported survey methods. Objective: To investigate pediatric nurses' real-world clinical adherence to basic infection prevention protocols and safe medication storage and handling regulations across public referral hospitals. Methods: A multicenter cross-sectional observational audit was conducted across pediatric departments in four governmental hospitals: Shandi Teaching Hospital, Al-Mak Nimr Teaching Hospital, Hosh Bannaga Hospital, and Al-Misktab Hospital. A total-coverage sample of 130 frontline bedside pediatric nurses was directly observed during routine medication rounds using an expert-validated clinical checklist comprising 11 basic infection control items and 3 medication storage parameters. Bivariate associations between nursing characteristics and clinical adherence were evaluated using Chi-square tests with statistical significance defined at p ≤ 0.05. Results: Direct clinical audits identified widespread compliance gaps across frontline pediatric units. Procedural hand hygiene was correctly performed in only 50.0% of encounters before and after drug handling, and in 53.8% upon direct patient contact. Strict aseptic injection preparation technique was observed in 46.2% of participants. Serious vulnerabilities were noted in parenteral device handling: only 40.0% segregated multi-dose vials within centralized clean medication stations, and dedicated single-patient insulin pen usage was restricted to 40.0%. Compliant pharmaceutical storage aligned with manufacturer temperature and light recommendations was observed in 46.2% of nurses. Bivariate analysis revealed that bachelor's degree qualification and extended clinical experience were significantly associated with higher clinical compliance (p < 0.05). Conclusion: Routine nursing compliance with basic infection control and safe medication handling remains critically compromised in public pediatric inpatient settings. Hospital administrations must establish centralized aseptic preparation stations, institute strict patient-specific device labeling policies, and sustain regular observational audits.

Background: Saudi Arabia’s health sector is undergoing substantial reform under Vision 2030, including expansion of insurance-based financing and private-sector participation. Evidence on the factors that shape patients’ choice between public and private hospitals in Jeddah remains limited. Objective: To identify demographic, socioeconomic, service, efficiency, and treatment-cost factors associated with patients’ choice of public versus private hospitals in Jeddah. Methods: A quantitative cross-sectional study was conducted among adults aged 18 years or older who had used a public or private hospital in Jeddah within the preceding 12 months. Data were collected using a structured online questionnaire adapted from a prior Saudi study. Of 429 respondents, 400 complete responses were analyzed. The final multi-item scales showed acceptable internal consistency (Cronbach’s alpha: services/facilities 0.878; efficiency/staff performance 0.823; treatment cost 0.729). Chi-square tests, independent-samples t tests, and binary logistic regression were performed in SPSS version 27. Results: Private hospitals were used by 69.0% of respondents. Hospital choice was associated in bivariate analysis with age, gender, nationality, employment status, health insurance, and family size. Public-hospital users reported higher mean service/facility and efficiency scores, whereas private-hospital users reported higher treatment-cost scores. In the adjusted model, these perception scales were not independent predictors. Health insurance strongly increased the likelihood of private-hospital use (OR=6.269, 95% CI 3.140-12.517; p<0.001). Income of at least SR 20,000 was also associated with private-hospital use (OR=6.722, 95% CI 1.072-42.140; p=0.042), while government employment (OR=0.147; p=0.002) and family size of 12 or more (OR=0.103; p=0.004) reduced the likelihood. Conclusion: Hospital choice in Jeddah appears to be driven more by structural enabling resources particularly insurance, income, employment-related access, and household size than by subjective perceptions of service quality, efficiency, or treatment cost after adjustment.

Background: Occupational burnout is a psychological response to chronic workplace stress and is particularly prevalent among nurses due to the high demands of the healthcare environment. In Saudi Arabia, nursing burnout is a growing concern, warranting targeted investigation. Aim/objective: To assess the prevalence of occupational burnout and examine its association with demographic and work-related factors among nurses at King Abdulaziz Hospital, Eastern Province, Saudi Arabia. Methods: The study included 295 purposively selected nurses. Data were collected using two instruments: a self-administered questionnaire covering demographic and work-related characteristics, and the Oldenburg Burnout Inventory (OLBI). Statistical analysis involved chi-square tests and binary logistic regression to identify predictors of burnout. Results: High overall burnout was reported by 8.1% of participants, with 26.8% experiencing high exhaustion and 23.0% high disengagement. Inadequate staffing was significantly associated with burnout (OR = 6.91, p = .001). Working in inpatient units showed a marginal association (p = .054). No other demographic or work-related factors were significantly associated. Conclusions: While the overall prevalence of high burnout was relatively low, a considerable proportion of nurses reported symptoms of exhaustion and disengagement. Perceived inadequate staffing emerged as the strongest predictor of burnout. Interventions such as optimizing nurse staffing levels and integrating stress management into nursing education are essential to mitigate burnout risk.