Background Nurses are usually the first to reach a patient in cardiac arrest. Yet their preparedness varies sharply from one clinical environment to another, and very little of this variation has been documented in Saudi Arabia. Aim To examine the relationship between CPR knowledge and self-efficacy among nurses across four distinct healthcare settings and to explore contextual barriers and facilitators influencing resuscitation preparedness. Methods A mixed-methods cross-sectional design was employed across healthcare facilities in the Eastern Province of Saudi Arabia, encompassing critical care units, inpatient wards, outpatient clinics, and primary healthcare centres (PHCs). Quantitative data were collected using the AHA BLS Knowledge Assessment (20 items) and the validated Resuscitation Self-Efficacy Scale (Roh et al., 2012; α = .91; n = 227). Analyses included Pearson correlation, one-way ANOVA with Tukey post-hoc tests, multiple linear regression, and intraclass correlation coefficient (ICC) estimation. Qualitative data were gathered through 22 semi-structured interviews analysed using Braun and Clarke’s [2] thematic framework. Results A significant positive correlation was identified between CPR knowledge and self-efficacy (r = .321, p < .001), with knowledge explaining 10.3% of self-efficacy variance (β = 0.592, p < .001). Significant inter-setting differences were found in both knowledge (F = 4.42, p = .005, η² = .056) and self-efficacy (F = 8.61, p < .001, η² = .104), with critical care nurses scoring highest (SE: M = 44.30, SD = 6.75) and outpatient clinic nurses lowest (SE: M = 37.74, SD = 5.43). The ICC indicated that 12.2% of self-efficacy variance was attributable to work setting. Six qualitative themes were identified: clinical exposure as the primary self-efficacy driver; fear of error and team dynamics as barriers; training for certification rather than competency; institutional support and debriefing as differentiating factors; psychological and emotional determinants; and contextual setting-level variation. Conclusions Gaps in CPR preparedness across settings cannot be explained by knowledge deficits alone; psychological and organisational factors carry more weight. Outpatient and primary care environments in particular need training built around simulation, and a routine practice of debriefing after resuscitation events.
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This study evaluated resilience levels and their key predictors among nurses working in hospital and primary healthcare settings in Eastern Saudi Arabia. A cross-sectional survey was conducted with 479 nurses using the validated Connor-Davidson Resilience Scale (CD-RISC-25). Multiple regression analysis was performed to identify predictors of resilience based on demographic and occupational variables, including years of experience, education, job position, and work setting. Hospital nurses demonstrated significantly higher resilience levels compared to primary care nurses. Resilience was positively associated with longer work experience and higher educational attainment. Nurses in supervisory or quality-related roles exhibited higher resilience than staff nurses. The findings underscore the importance of institutional and educational support in fostering resilience among nurses. Tailored interventions, especially within primary healthcare settings, are essential to strengthen coping capacities and promote psychological well-being in the nursing workforce. Not applicable.
Directional drilling in the subject field is a challenge, especially in horizontal producer wells targeting shallow reservoirs. More than 25% of the NPT while drilling the curve section in the subject field is related to trajectory. The high DLS requirements limit the BHA design, and drilling those curved sections with a directional motor requires long sliding intervals. This reduces the overall ROP due to poor weight transfer and increases the stress on the surface equipment because of the high surface WOB required. To overcome these challenges, an advanced combo directional motor with a 1.5 adjustable-bend-housing (ABH) was paired with a short gauge 12.25-in PDC bit. This combination improved directional control and penetration rates. An Agitator Drilling System (ADS) was integrated into the bottom hole assembly (BHA), positioned 850 feet from the motor to minimize friction and boost weight transfer efficiency. The distribution and size of heavy weight drill pipes (HWDP) were optimized to enhance stability and weight transfer. A comprehensive hazard and risk matrix was developed to preemptively address potential issues, and stakeholder meetings were held to ensure alignment on objectives and strategies. Additionally, continuous follow-ups were conducted to monitor progress and implement real-time adjustments as needed. The deployment of the advanced directional motor and drilling agitator resulted in substantial improvements in drilling performance. In the initial run with the new BHA configuration, there was a remarkable 15.7% increase in the ROP in the 12.25-in section compared to previous operations. This improvement was a direct result of enhanced directional control and reduced friction, which facilitated smoother and faster drilling. Weight-on bit (WOB) transfer also saw a notable improvement. The optimization of the HWDP distribution and the integration of the agitator led to a 15% improvement in WOB transfer efficiency from depths of 3000 ft to 6200 ft. Additionally, the maximum WOB was reduced from 60 klbs to 48 klbs, which contributed to a decrease in equipment stress and increased operational safety. The strategic placement of the drilling agitator successfully minimized shock levels on measurement while drilling (MWD) equipment, reducing potential data inaccuracies and equipment failures. The combination of these factors resulted in a more efficient drilling process, with fewer interruptions and enhanced stability. The successful implementation of this innovative approach established a new benchmark for drilling performance in similar challenging conditions, demonstrating significant potential for future applications and advancements in the industry.
