Reports & Publications
Bottleneck factors impacting nurses' workflow and the opportunity to prioritize improvement efforts: factor analysis
Al Moteri, M., Aljuaid, J., Alsufyani, B., Alghamdi, A., Althobiti, E. S., & Althagafi, A. (2024). Bottleneck factors impacting nurses’ workflow and the opportunity to prioritize improvement efforts: factor analysis. BMC nursing, 23(1), 640. https://doi.org/10.1186/s12912-024-02311-2
Abstract
Abstract
Purpose: Minimizing delays in delivering nursing care is paramount for enhancing the overall quality of care. Certain bottleneck variables restrict the workflow of nurses, resulting in extended shift times. This study is designed to pinpoint and analyze the principal factors contributing to bottleneck issues in nursing workflow, to direct improvement endeavors. This study seeks to provide insights into the key variables contributing to nurses’ extended shift times, with the ultimate goal of prioritizing efforts for improvement.
Methods: A descriptive multicenter cross-sectional study was conducted. A scale was developed for this study by the authors after conducting a literature review, subsequently validated, and its reliability was assessed.
Results: Among the 31 bottleneck variables, 29 were retained under three persistent bottleneck factors: (1) Nurse staffing- This pertains to the availability of sufficient nursing staff at all times across the continuum of care; (2) Working environment and quality of care-This refers to the availability of necessary skills and resources for nurses to perform their duties effectively and; (3) Medical devices- This factor concerns the availability of fully functional medical devices required for providing care.
Conclusion: Efforts aimed at enhancing the overall healthcare system should concentrate on addressing persistent bottleneck factors. This may involve the implementation of a healthcare workforce management system, the establishment of standards for a conducive and supportive working environment, and the utilization of a standardized system for the management of medical equipment. The outcomes of this study can be utilized by nurses and policymakers to devise comprehensive strategies for improvement.
Keywords: Device; Equipment; Medical; Nursing; Productivity; Staffing; Work-flow.
Implementation lead nurses to lead EBP quality improvement project using the PEACE framework
Aljuaid, J., & Al-Moteri, M. (2024). Implementation lead nurses to lead EBP quality improvement project using the PEACE framework. Nursing & health sciences, 26(3), e13153. https://doi.org/10.1111/nhs.13153
Abstract
Abstract
Implementing evidence-based practice (EBP) in clinical practice is an ongoing challenge for nurses. EQUIP-Evidence-based QUality Improvement Project- is a multiphase project aimed at equipping nurses with the essential skills to implement EBP and advanced nursing practice. EQUIP embraces the assumption that implementation science models and partnership models can facilitate the implementation process of EBP, leading to successful and sustainable change. The current study is one of the EQUIP feasibility investigations in which the perspective of 12 implementation lead nurses (IL nurses) who attended a 1-day PEACE-based workshop was explored. Thematic analysis identified 2 overarching themes, 6 themes, and 18 subthemes. The first overarching theme showed that the PEACE-based workshop has successfully achieved its intended training implications, and the second overarching theme gave insight into factors that may influence the role of IL nurses. IL nurses reported general satisfaction and willingness to use the PEACE model at work; however, some IL nurses found Step 3 difficult to apply. The study’s findings provide evidence of the perceived usefulness of adopting the PEACE model as an augmented approach in the EQUIP and the interest and enthusiasm of IL nurses in receiving more training on the implementation process of EBP.
Implementation Science Competencies for Policy Transformation Framework (ISCPT)
Abstract
Abstract
Implementation science (IS) models play a crucial role in translating evidence-based practice (EBP) into sustainable policy reforms. However, the competencies required for nurses to lead these transformations remain poorly defined. Objective: This study develops a framework for implementation lead (IL) nurses, identifying the core competencies needed to drive evidence-based policy transformation within healthcare systems. Method: A secondary data analysis (SDA) was conducted using qualitative data from focus group interviews originally collected, recorded, and transcribed as part of the EQUIP (Evidence-based Quality Improvement Project). The dataset includes insights from 12 IL nurses who participated in PEACE-based training, addressing real-world clinical challenges. Their perspectives were thematically analyzed to generate a competency framework for policy leadership. Findings: The study developed the Implementation Science Competencies for Policy Transformation (ISCPT) framework, which highlights three pillars: (1) evidence appraisal and guideline development, (2) collaborative leadership for policy advocacy, and (3) continuous improvement through data-driven decision-making. Conclusions: Grounded in IL nurses’ perspectives, the ISCPT framework provides a nurse-centric roadmap for policy transformation, integrating interdisciplinary collaboration, adaptive leadership, and evidence-based decision-making into nursing education and practice. While the findings reflect a single healthcare context, the framework offers actionable guidance for preparing nurses to lead policy-driven healthcare improvements.
Development of an Implementation Science Higher Diploma for Registered Nurses: Phase III of the EQUIP Initiative
Al-Moteri, M. and Aljuaid, J. (2025), Development of an Implementation Science Higher Diploma for Registered Nurses: Phase III of the EQUIP Initiative. Nurs Health Sci., 27: e70062. https://doi.org/10.1111/nhs.70062
Abstract
ABSTRACT
Implementation science (ImpSci) programs are emerging in nursing postgraduate education. The Evidence-Based Quality Improvement Project (EQUIP) is a multiphase initiative aimed at equipping implementation lead nurses (IL nurses) with the skills necessary for practice changes. This study leveraged EQUIP’s outcomes to develop a 1-year Higher Diploma in ImpSci for registered nurses, preparing graduates to conduct ImpSci projects that improve healthcare quality. Using a co-participatory design, the study engaged IL nurses (n = 10), clinician nurses (n = 3), clinical research nurses (n = 1), and academic staff (n = 2) in collaboratively developing the ImpSci Higher Diploma curriculum. Six co-designed learning domains were established, aligning with the program’s mission to advance evidence-based education, research-driven clinical practice, and sustainable quality initiatives, with a focus on ImpSci. Nine program learning outcomes were mapped to eight domains of competence, creating a framework to prepare IL nurses to conduct ImpSci projects, address challenges, and improve patient outcomes. ImpSci Higher Diploma builds on previous work in evidence-based practice (EBP) implementation, equipping graduates to lead critical quality improvement efforts and advance nursing education and healthcare delivery.
