Allied Healthcare encompasses various professions involved in diagnosing, evaluating, and preventing diseases and disorders. Allied Healthcare Institutes (AHIs) provide education and training in ...these professions. However, there is currently a lack of explicit guidelines for ensuring quality excellence in AHIs. This narrative review aims to address this gap by examining existing literature on quality assurance in AHIs and proposing a conceptual framework that outlines essential components for establishing a high-quality AHI. A comprehensive search of PubMed and Google Scholar electronic databases yielded 86 relevant articles, which were analyzed and grouped into Nine themes related to the study's objectives. These themes include leadership in AHIs, student selection and support, teaching quality, curriculum development, research opportunities, stakeholder involvement, quality improvement initiatives, the impact of accreditation/certification, and physical facilities. Based on the review, the study presents 33 carefully formulated recommendations. By implementing these guidelines, policymakers and those interested in establishing AHIs can create institutions that promote the acquisition of new knowledge and skills, foster research and development, and provide excellent educational resources.
Improved outcomes for patients on mechanical ventilation may be achieved with early mobilization (EM). However, it is not clear how widely this strategy is adopted into routine intensive care unit ...(ICU) practice in Saudi Arabia.
This study was conducted to describe the present practices and challenges to providing EM for mechanically ventilated patients, which may drive dissemination and implementation activities.
We approached 205 ICUs across Saudi Arabia using a validated tool to assess ICU characteristics, the practices of EM for mechanically ventilated patients, and the barriers to providing EM.
We approached 205 ICU persons in charge and achieved a 65% response rate (133 ICUs). The prevalence of EM for mechanically ventilated patients was 47% (63 ICUs). A total of 85 (64%) of the respondents reported having no previous training in EM. The absence of a written protocol was reported by 55% of the ICU practitioners in charge, 36% started EM within 2 to 5 days of critical illness, and 35% reported that performing EM for mechanically ventilated patients was totally dependent on physicians’ orders. Forty-seven percent of the ICUs that practised EM had at least one coordinator or person in charge of facilitating EM. The highest level of EM with mechanically ventilated patients was 35/63 (55%) with patients remaining in-bed and 28/63 (45%) with patient getting out of bed. A majority of the respondents (39, 64%) performed EM once daily for an interval period of more than 15 min. Previous training in EM and years of experience of the ICU person in charge were significant factors that promoted EM for mechanically ventilated ICU patients (OR: 7.6 (3.37–17.26); p < 0.001 and OR: 1.07 (1.01–1.14), p = 0.004, respectively). Existing protocols increased the odds of starting EM within 2 to 5 days of critical illness by six-fold (OR: 6.03 (1.79–20.30); p = 0.004). No written guidelines/protocols available for EM, medical instability, and limited staff were the most common hospital-, patient- and health care provider-related barriers to EM in the ICUs, respectively.
The prevalence of EM for mechanically ventilated patients across Saudi Arabia was 47%, although only 36% of the ICU staff had previous training in EM. Targeting modifiable barriers to EM, including a lack of training, guidelines and protocols, and staffing, will help to promote EM in Saudi Arabian ICUs.
