**Tec Empresarial** is an academic journal that publishes scholarly articles and research findings. The journal focuses on topics related to business, management, and entrepreneurship. It aims to provide a platform for academics, researchers, and professionals to share their knowledge and insights on various aspects of business administration and corporate strategies. The journal may include a wide range of topics such as: - Business innovation and technology - Marketing strategies and consumer behavior - Organizational behavior and leadership - Finance and investment management - Economic policies and their impact on businesses - Human resources management and development - Strategic management and corporate governance **ISSN**: 1659-2395 **E-ISSN**: 1659-3359 Tec Empresarial is dedicated to promoting academic excellence and advancing knowledge in the field of business studies. It serves as a valuable resource for scholars, practitioners, and policymakers interested in the latest research and trends in the business world. The journal may also provide a space for discussions on contemporary issues and challenges faced by businesses globally.
ROLE OF NURSING EDUCATION LED BY CLINICAL PHARMACISTS IN PREVENTING MEDICATION MISCALCULATIONS
Correct and precise medication management is an essential task for health professionals and a key determinant of patient safety. Despite advances in medical technology, the medication process remains particularly vulnerable to error. Miscalculations of drug dosages, amounts, and concentrations place the patient at risk of under- or overdosing regardless of the route of administration or medication used (Jaam et al., 2021). Depending on the characteristics of the drug and the patient, medication miscalculations can be considered a critical, high-risk error that may have serious consequences. Miscalculations may also lead to medication omission, delays, or repetition, which can further delay treatment, prolong hospitalisation, and increase the cost of care (Maley & Ford Garofalo, 2017). From the perspectives of regulatory authorities, professional societies, and patients and families, miscalculations represent an important quality and safety issue. Mitigating the risk of miscalculation must therefore be a priority for educational institutions and healthcare organisations. Reducing this type of error is a shared responsibility, and nurses play a key role in medication administration and therefore constitute a critical stakeholder. Nevertheless, studies have shown that nurses’ competencies in this area are frequently inadequate and poorly integrated into training programmes. The dispersion of concepts and calculations across disciplines furthers the challenge, even appearing to orient training more towards registration than acquisition of actual competencies. Implementing a targeted approach to education is thus vital for ensuring that nursing professionals receive the preparation required to mitigate the risk of medication miscalculations.
nursing education, clinical pharmacists, medication miscalculations, medication safety, dosage calculation, interdisciplinary training, error prevention
Bashayer Firas Alrumayyan, Abdullah Hadi Alanezi, Alaa Turki Alturki, Mohammed Sulaiman Abdulkarim and Alkhuzama Hasson Alhasson
PRE-MRI SCREENING ERRORS: A JOINT REVIEW BY RADIOLOGY AND ANESTHESIA TEAMS
Radiology and anesthesia teams collaboratively reviewed pre-MRI screening errors, key gaps affecting patient safety and risk management, and systemic factors contributing to omissions. Remedial measures to improve screening quality include standardized protocols, structured checklists, integration with electronic medical records, interdisciplinary communication frameworks, and formal training with competency assessments. Improving pre-MRI safety screening—especially for sedation cases—between 2020 and 2023, the radiology and anesthesia teams collaboratively analyzed pre-MRI screening errors recorded in the institution’s incident reporting system. The joint review highlighted essential omissions that could compromise patient safety and indicated systemic factors leading to errors. Pre-MRI screening aims to detect contraindications, identify safety hazards, ensure equipment availability, capture medical history, and select the optimal protocol for patients undergoing magnetic resonance imaging (MRI) (Vosshenrich et al., 2021). Screening remains crucial when anesthesia or sedation is required, as MRI presents challenges in providing care while monitoring patients (Batty et al., 2019). MRI screening errors have been cited by multiple sources as high-risk omissions during monitored anesthesia care, with anesthesia teams remaining directly responsible for eligibility assessment.
radiology, anesthesia, safety, screening, pre-MRI, errors, collaboration, quality improvement
IMPACT OF PHARMACIST–NURSE COLLABORATION ON HIGH-ALERT MEDICATION ADMINISTRATION
Highly effective systems reducing mortality that are under-used and poorly understood are an impediment to high-quality health care, yet collaborative interprofessional practice (IP) in which nurses and pharmacists routinely work together to support the safe administration of high-alert medications meets the criteria for the designation. Involvement of pharmacists can directly address the patients' situation, iteratively helping to guide those on high-alert medications toward more normal parameters or away from high-alert altogether; or through broader collaboration on the process design providing standardization and reducing inadvertent pathway changes that can increase risk and cause unexpected harm, while preserving resilience to meet the changing needs of the patients and ensuring ongoing appropriate active oversight of the entire pathway.
High-alert medications; pharmacist–nurse collaboration; medication error; patient safety; interprofessional communication; health information technology; medication-system gaps; systematic review.
Nawal Mohammed AlAtiyyah1 and Sami Nasser Alfatat2
REDUCING ADVERSE EVENTS DURING MRI SEDATION THROUGH IMPROVED RADIOLOGY–ANESTHESIA COMMUNICATION
In children undergoing magnetic resonance imaging (MRI) sedation, communication failures between radiology and anesthesiology contribute to multiple adverse events. Inconsistent models for such interaction further complicate efforts to mitigate risk in this vulnerable population. To better understand these challenges, a survey of communication practices between radiology and anesthesia during MRI sedation at a large, multispecialty academic medical center was conducted. Sedation remains a common requirement for MRI studies in children, despite the effort to avoid it owing to associated risks. The requisite collaboration with anesthesia tends to be informal, with minimal technology involved and wide variation in team adherence to safety practices (Mitra et al., 2020). Numerous adverse events related to sedation still occur, including patient movement compromising scan quality, excessive monitoring, protracted study duration, and interruptions linked to patient or technician miscommunication. These concern the broader institution, as radiology and anesthesia often receive separate accreditation and the reported incidents reflect on quality of care and patient safety (Muyiwa Owojuyigbe et al., 2017). Communication links enabling effective collaboration are not yet well documented in imaging or anesthesia literature.
Adverse Events, MRI Sedation, Radiology, Anesthesia, Communication, Patient Safety, Interdisciplinary Collaboration, Sedation Management, Perioperative Care, Risk Reduction
Eman kasab alanazi1 and Ahmed Mohammed Asiri2,Khalifa Abdulrahman Al-Shuwaihi3
FUNDAMENTALS AND PRACTICES OF PREVENTIVE MEDICINE AND PUBLIC HEALTH
Preventive medicine is a specialty that focuses on the health of the population as a whole, rather than on specific diseases in individual patients. Its underlying philosophy is that health is a valuable asset that enhances quality of life and productivity, and that disease, injury, and other health problems should be prevented whenever possible. Public health is often viewed as synonymous with preventive medicine, as its objective is to improve and protect the health of the community and establish policies that prevent health problems. Preventive medicine and public health practitioners play a vital role in this by designing, implementing, and evaluating effective interventions. The aim of this text is to provide a concise overview of preventive medicine and public health fundamentals, covering definitions, history, resources, levels of prevention, the epidemiologic triangle, and examples of public health intervention. It is hoped that this overview will be useful in understanding and conserving community health, and that it will inspire further public health endeavors. Preventive medicine and public health are terms that are often used interchangeably. Preventive medicine is a specialty recognized by the American Board of Medical Specialties that traditionally aimed to prevent diseases and injuries in specific populations, such as children in private practice. However, the emphasis transitioned to public health. Public health is a broader field that encompasses preventive medicine professionals and non- physicians engaged in similar activities, including epidemiologists and health planners. Health is defined as "a complete state of physical, mental, and social well-being," not just the absence of disease. This definition has been contested, as it implies that those who are elderly or disabled are unhealthy. Health is a valuable asset that enables individuals to lead happy lives, enhances productivity, and is fundamental to national growth and development.
Ahmed Mohammed Aati1, Nasser Mishaal Nasser Al-Muthib2, Walid Ahmed Haser Sahli3, Ali Yahya MOHAMMED Atee4, Abdulrahman Marzouq Al-Otaibi5 , Noura Mohammed Muslim Al-Subaie6, Sarah Dhaidan Mohammed Al-Subaie7, Dr. Nedaa Mohammed Ali Alromaili8, Dr. Hanin Raja Saleh Aloufi 9, Eman Tuwairesh Alenazi10, Tamam Ayed Alenizi11 and Khaled fares alsubei12
COLLABORATIVE DECISION-MAKING AMONG PHYSICIANS, NURSES, AND ALLIED HEALTH PROFESSIONALS IN SAUDI ARABIA
Saudi Arabia aims to strengthen interprofessional collaboration as part of a broader reform agenda aimed at improving health outcomes, reducing healthcare costs, and achieving universal health coverage in accordance with Vision 2030. Engaging all health professionals in joint decision-making is essential for the successful delivery more urgent strategic priorities of health system reform. Scientific evidence and statistical data consistently demonstrate that collaborative decision-making among physicians and allied health professionals significantly improves patient care, shortens hospital stays, and reduces overall treatment costs (I. AlHaqwi et al., 2015). At present, the general level of cooperation and coordination between doctors and other professionals remains limited. Joint decision-making currently takes place in some clinical settings but not systematically throughout the continuum of care; parallel approaches predominate in individual visits and after referral to specialists (Alrawiai et al., 2020). The objective of this work therefore is to shed light on current practices of inter-professional teamwork and collaborative decision-making within the Saudi healthcare system. The analysis highlights specific obstacles and enablers to the effective participation of nurses and allied health professionals in collaborative teamwork. It draws on cross-disciplinary evidence, global standards, empirical research, and theoretical frameworks relevant to shared decision-making in order to clarify the rationale for strengthening interprofessional involvement. A detailed overview of the salient organizational, regulatory, procedural, and cultural factors influencing joint decision-making within the Saudi context is provided, with the aim of informing policy development and practical reforms in the pursuit of collaborative practice.
Collaborative, decision-making, Saudi Arabia, interprofessional, physicians, nurses, allied health
Lina Shaman Wahsh Alanazi1, Maha Shafea Alhawsawi2, Hind Abdullah Alharbi3, Kholoud Nasser Alrami4, Maryam Hamad Baqees5, Mousa Fahad Mousa Alanazi6, Khairat Abdulaziz Medkhali7, Nawal Mohammed AlAtiyyah8 and Fatimah Mohammed Alkathiri9
ASSESSMENT OF BIOMEDICAL EQUIPMENT MANAGEMENT AND MAINTENANCE SYSTEMS IN SAUDI HOSPITALS: A SYSTEMATIC REVIEW
This systematic review examines the current state of biomedical equipment management and maintenance systems in Saudi Arabian hospitals. Eleven studies were analyzed to assess regulatory frameworks, maintenance models, CMMS adoption, workforce readiness, and operational challenges. Results indicate significant variability across hospitals, with dominance of corrective maintenance, underutilization of CMMS capabilities, weak HIS integration, shortages in trained biomedical engineers, and procurement delays. The review highlights critical gaps that affect equipment availability, reliability, and patient safety. Recommendations emphasize stronger regulatory enforcement, investment in workforce development, expansion of preventive maintenance programs, and integration of data-driven decision-support tools. The situation is aggravated by limited government interventions, inadequate administrative documents, insufficient guidelines or standards, and BME management programs focused on maintenance instead of utilization. In recent years, extensive renewable energy projects have been initiated worldwide to reduce CO2 emissions. In Saudi Arabia, renewable energy is an integral part of the Saudi Vision 2030’s program on the diversification of the economy. Various technological options for producing renewable energy are available. Yet, the economic viability of these renewable technologies has to be established before large-scale deployment. Consequently, an analytical study is completed to appraise four renewable energy technologies in the perspective of their costs and benefits. The outcome suggests that solar and wind energy technologies should be considered as the best alternative to fossil fuel energy in Saudi Arabia. The experiment on weaving an inversion is undertaken using graphical information. A complete set of solutions obtained for five consumer specification problems suggest the necessity of determining the inversion of the industry target input requirement coefficients. Further, the assumption of a linear target fund constraint is also discussed.
Biomedical equipment management; maintenance management; biomedical equipment maintenance; biomedical equipment lifecycle; biomedical equipment performance; biomedical engineering; medical equipment management.
Abdullah Saad Abdullah Alamri1, Mohammed Fahad Mohammed Alqahtani2, Ahmed Saad Mohammed Al Ghamdi3, Fahad Mohammad Awadh Alshahrani4 and Faisal Mshabab Abdalrhman alotaibi5
THE ROLE OF HEALTHCARE PROFESSIONALS IN QUALITY CARE DELIVERY
Healthcare professionals play a vital role in the delivery of quality care. Understanding the historical and contemporary view on healthcare professionals and their role improves the understanding of quality care delivery. Various qualities, skills, and education possessed by healthcare professionals enhance the delivery of healthcare. Healthcare professionals have a professional obligation to society and the public. Therefore, it is essential to understand the medical, nursing, and allied healthcare professionals' role in the quality delivery of care. Healthcare professionals often face ethical concerns while dealing with patients. The pandemic affected the well-being of healthcare professionals in several ways. There is currently a burnout among healthcare professionals, which not only affects their health but also affects patient safety (Bhardwaj, 2022). However, there are various interventions that ensure the well-being of healthcare professionals. Healthcare professionals are the backbone of any healthcare system. Therefore, it is essential to understand the role of healthcare professionals in safe and quality care delivery. The advancement of technology, the pandemic, and quality improvement initiative have impacted how healthcare practice is delivered and developed. There is a growing interest in the role of healthcare professionals in enhancing the delivery of healthcare. The care need is generally assessed through a triaging process, where the patient needs to be the focus and center of care. Although healthcare professionals possess diverse training and expertise, in the past, there was an overlap of delivery care among different health professionals. Currently, there is a need for patient- centered care to be delivered by a primary healthcare professional. However, this also requires a collaborative approach from all the involved professionals. A wide variety of skills and attitudes are needed for healthcare professionals to work in a patient-centered approach. Diversity among healthcare professionals improves access to care and is associated with better clinical outcomes ((Arend R.) van Stenis et al., 2017). Future consideration should focus on the different objectives and measures of success in the care network and how this impacts the role of healthcare professionals. Furthermore, directions for future research should enhance the understanding of the role of healthcare professionals in quality care delivery.
healthcare professionals; quality care; quality improvement; patient care; interprofessional healthcare; healthcare burnout; healthcare training; healthcare roles
Mubarak Salem Ghannam Alsahli1, Majid Farhan Al-Mutairi2 ,Mohammed Ali Mohammed Saleh3, MOHAMMED SAAD AJAB ALOTAIBI4, Faisal Bandar Jamal Alotaibi5, Mohammed Ali Khadran6 , Mohammed Ali Mohammed Al-Shahrani7 , Abdulaziz Hilal Barakat Al-Mutairi8, Naji Hassan Mohammed Al-Mansouri9, Abdulmalik Ibrahim Al-Abdulsalam10, Mohammed Abdullah Al-Qahtani11 and Faisal Musleh Mohammed Alshehri12
NAVIGATING HEALTH CHALLENGES: HOW HEALTH PRACTITIONERS SUPPORT PATIENTS IN CARE
People with long-term health conditions navigate a variety of physical, emotional, social and practical challenges. Health practitioners play a critical role in supporting patients to address the challenges they face in care. This article examines health practitioners’ actions to support patients in care and describes the range of ways practitioners help patients address health-related challenges. Narratives from a large-scale study with patients who have long-term health conditions are drawn upon to illustrate how practitioners support patients in care. Four categories of action practitioners take to support patients in care are described: practitioners provide (i) emotional public recognition of patients’ challenges; (ii) knowledge and advice about health challenges; (iii) practical assistance with care procedures; and (iv) encouragement and assistance to connect patients to social support networks (F. Sheridan et al., 2019). Understanding how practitioners support patients in care illuminates the collaborative nature of care and the importance of practitioner actions in enabling effective patient engagement in care.
Mohammed Abdulrahman Furthaj Alazmi1, Sami Saeed Abdullah Alghamdi2,Nawaf Sayer Turkey Alenzai3, Fahad Abdulmoen Alotaibi4, Mutual Mohammed Almutairi5, Turki Ahmed Ibrahim Alasiri6, Ahmed hamza Abdulrahim Aljohani7, Ali Saeed Ali Alqarni8, TURKI HELAL HAMOUD ALOSAIMI9, Hamoud Saleh Al-Mutairi10, KHALID ALI MANSUR ALHARBI11 and Sultan Salem Alsahli12
COMPREHENSIVE CARE: THE INTEGRAL ROLE OF FAMILY PHYSICIANS IN PATIENT WELL-BEING
With growing concerns regarding health equity, accessibility, and sustainability of health systems, there is a critical need to mobilise a trained health workforce to provide necessary care in low-resourced communities. A possible solution is community-based primary care teams led by family physicians, akin to the “health house” model in Iran and the Family Health Strategy in Brazil. Family physicians provide key aspects of primary care—first contact care, comprehensive care, coordination, and personalisation of care—enabling them to lead community-based primary care teams (P. MF Rahman et al., 2023). Community-based care teams led by family physicians could adequately address health concerns in low-resourced communities while optimally utilising a trained health workforce. To explore the possibilities of family physician-led primary care teams to provide necessary care in low-resourced communities, three patients’ stories are presented who experienced diverse care at community clinics in South India. Aging causes various health problems in older people that can decrease their quality of life (QOL). Such medical problems cannot be solved solely by healthcare professionals, because they can be connected to psychosocial problems, reinforcing the need for interprofessional collaboration (IPC) (Ohta et al., 2021). Multiple health problems must be approached by various healthcare professionals, each with different knowledge. For example, medical professionals must effectively deal with multimorbidity, and care professionals need skills to Support older people by collaborating with families and social support systems. Medical care must transition from hospitals to clinics and communities, and community care prevent health problems from escalating to a higher care level. Therefore, communities must be able to independently address health problems.
Faisal Ibrahim Hamad Aljurbua1,Hassan Abdullah Al Madwaha Asiri2, Haneen Bashit Madsous Al-Anazi3, Bandar Abdulmoein Al-Otaibi4 , Dr. Hamza Kayed Srour Alotaibi5, Dr. Hamed Mohsen alshammari6, Senior Ph. Hamdan Mohsen ALSHAMMARI7, Hadeel Saad Aldousari8, Faiyadh Mohsen Mohammed Alshammari9 Mohammed Saad Muslat Al-Sahli10, YOUSEF SULTAN RAKAN ALANAZI11 and RAYED FARHAN ABDULLAH ALSHEHRI12
THE CRITICAL ROLE OF PHLEBOTOMY SPECIALISTS IN ENSURING BLOOD QUALITY AND SAFETY IN BLOOD BANK OPERATIONS
The importance of quality in specimen collection is critical in pathology and a prerequisite for accurate laboratory diagnosis. The specimen collection process, particularly venepuncture or phlebotomy, is an exceptionally challenging “pre-analytical” step in the laboratory diagnostic chain. It introduces a wide spectrum of variables that can influence the both the patients’ safety and the laboratory results owing to the risk of contamination and handling stages when specimens are left at room temperature, centrifuged time and temperature, time limits before tests deadlines and so on. As over 70% of clinical decisions are based on laboratory tests, ensuring quality in this chain, including specimen collection, is a necessity if patient safety, and laboratory quality objectives are to be achieved. Quality improvement efforts are a continuous process. Consequently, a critical review on quality-related issues in phlebotomy, a quality assurance system designed specifically for phlebotomy, the relevant quality standards and the various approaches to maintain and improve quality as well as details of a feedback system on phlebotomy quality in blood banks is presented for consideration. Phlebotomy is the procedure of collecting blood samples, primarily from veins for laboratory tests. It is a common medical procedure for disease diagnosis and management through specimen collection such as sputum, plasma or urine. Quality assurance is a core element in laboratory accreditation, and effort is focused on this aspect, since it has received little attention despite its importance. Blood transfusion is regarded as the highest-risk procedure in health care .
Quality; Safety; Phlebotomy; Blood; Quality Assurance; Error; Training; Practice.
PHLEBOTOMY AND BLOOD BANKING: A COLLABORATIVE APPROACH TO TRANSFUSION SAFETY
Phlebotomy and blood banking are closely interlinked disciplines that collaborate to provide safe and effective transfusion therapy. Safety remains an essential issue during and after transfusion. Despite significant advances, transfusion remains an integral part of modern medicine, highly relied upon in surgical procedures, oncological patient treatment, and multiple hematological afflictions. Collected samples sent to the blood bank must be properly handled to prevent any time loss between collection and analysis, as this would hamper the database system used for communication with the prescribing doctor. In the past decade, tremendous advances have been made in laboratory technology and testing automation; however, human errors remain formidable, resulting in longer turnaround times. Transfusion cannot be appreciated purely as a technical process; instead, it must be perceived as a continuum of laboratory services spanning from cross-matching to proper follow-up of adverse effects, emphasizing the health care professional’s responsibility in this life-saving therapy. Phlebotomy and blood banking possess distinct information technologies operating independently from one another. Hence, additional pre-analytic specifications must be respected to ensure that compatibility testing remains free from human error, and to prevent erroneous sample processing which may further interfere with sample integrity. Baseline phlebotomy education is often neglected within the transfusion perspective, leaving inexperienced technicians ill-prepared to provide a timely transfusion. Furthermore, both disciplines share full accountability for transfusion therapy, even if their individual responsibilities are not interdependent .
Phlebotomy / Blood Banking, Transfusion Safety, Pre-analytical Phase, Traceability, Blood Compatibility Testing, Patient Identification, Continuous Improvement, Emerging Technologies.
ASSESSMENT OF EMERGENCY PREPAREDNESS AND RESPONSE CAPABILITIES AMONG MULTI-SPECIALIST HEALTHCARE PROVIDERS
Emergency preparedness and response capabilities among multi-specialist healthcare providers remain largely unexplored. A cross-sectional assessment of these capabilities across six disciplines was performed to support enhanced clinical preparedness. Emergency preparedness was defined via 12 essential domains grouped into five capability areas: coordination, communications, decision-making, equipment, and personnel. Findings indicated overall preparedness levels of 5.1 on a 10-point readiness scale, reflecting substantial opportunities for improvement. Response capabilities shortly after an emergency event scored 5.4, again suggesting considerable room for development. Multiple response competencies across specialties, timeliness, coordination, and decision-making capabilities varied, while similar communications functions emerged. Training opportunities were also frequently identified, as were deficits in drills, continuing education, and essential equipment. Multi-specialist emergency preparedness assessment remains broadly unexamined, with particular limitations affecting resources and guidance tailored to coordinated training and planning intervention. The present study sought to explore preparedness and response capability in multi-specialist care settings across Texas, focusing on the deliverance of pre-emptive care. A corresponding need for assessment was established through a preliminary inquiry evaluating separate multi-specialist configurations within and between comprehensive emergency response teams (Habte Woyessa et al., 2020).
Emergency preparedness and response, multi-specialist healthcare providers, cross-specialty emergency management, cross-sectional study, quantitative preparedness assessment, evaluation of training requirements, identification of additional resources.
Wadyan Faisal Al -Awfi1, Munirah Nasser Alsahli2, Lulu Khalid Aljasir3, Ahmad Ali Alabsi4, Abdulaziz sahab Almutairi5 and Jawaher Mnawer Almutairi6
ARTIFICIAL PANCREAS SYSTEMS: INTEGRATION OF CONTINUOUS GLUCOSE MONITORING WITH AUTOMATED INSULIN DELIVER
Artificial Pancreas Systems integrate continuous glucose monitoring with automated insulin delivery. Automated insulin delivery systems, also known as closed-loop or ‘artificial pancreas’ systems, are transforming the management of type 1 diabetes. These systems consist of an algorithm which responds to real-time glucose sensor levels by automatically modulating insulin delivery through an insulin pump (Lakshman et al., 2023). Advances in algorithms, reliable glucose-sensing technologies, and devices that facilitate insulin delivery are leading to the development of closed-loop systems that can function within the required operational and safety envelopes, offering the prospect of achieving automated diabetes control. A hybrid closed-loop system is used, into which the user specifies a target glucose level—usually set between 5.0 and 7.5 mmol/L—and from which the user can resume intermittent self-monitoring of blood glucose (SMBG) or suspend the closed-loop operation (Wayne Bequette et al., 2016).
Artificial Pancreas Systems integrate continuous glucose monitoring with automated insulin delivery (Lakshman et al., 2023)
Khalid Jameel Alotaibi, Haifa Abdulaziz Alhowaidi, Mohammed Ali BinQasim, Mohammed Dughays Fatq Alotaibi and Saleh Ibrahim Alamri
SELF-MEDICATION WITH PROTON PUMP INHIBITORS AND ITS ASSOCIATION WITH GASTROINTESTINAL SYMPTOMS
Self-medication with proton pump inhibitors (PPIs) is frequently practiced in many populations and commonly reported by patients with gastrointestinal (GI) complaints. Numerous studies worldwide reveal a high prevalence of such self-medication, even with prescription-only PPIs, while little is known about the gastrointestinal outcomes associated with PPI self-use. The present study sought to delineate these outcomes and identify the self-medication practices related to them. Various self-medication strategies have been identified, allowing for comprehensive comparison across studies. Patterns of PPI self-use are especially concerning among the younger and more economically privileged populations of the Global North, as well as among the impoverished and marginalised communities of the Global South. The use of self-diagnosis criteria, self-diagnostic related comfort thresholds, and alternative access routes for self-medication are also widespread. Some specific factors are regularly recorded, including ongoing circumstances before initiating self-medication and the symptom output that motivates it, yet individual asymptomatic time and health-seeking attempts before PPI use go largely unreported.
PPI self-medication, over-the-counter PPIs (OTC), rebound acid hypersecretion (RAHS), long-term use risks, inappropriate use, chronic kidney disease (CKD), malabsorption (B12/magnesium), C. difficile infection, SIBO (small intestinal bacterial overgrowth), gastritis.
Fahad Sulaiman Almousa, Afnan Nasser Alotaibi, Saud Abdullah Bashir Al-Anezi
CHALLENGES OF NOVEL MOLECULES AND THE ESSENTIALS OF APPROPRIATE ANTIBIOTIC USE
The health threat posed by pathogenic antibiotic-resistant bacteria has grown considerably during the last two decades, primarily due to the overuse and abuse of existing antibiotics and the inevitable evolution of microorganisms through selective pressure. New active pharmaceutical ingredients targeting the same biological mechanisms have proven generally ineffective against multidrug-resistant (MDR) pathogens. The drug-development pipeline for antibacterials has also dwindled sharply; since 1984, only two new classes have reached the commercial market. Emerging trends indicate, however, that many new şi and scientifically innovative approaches for discovering novel antibiotics are being pursued to address this challenging global health crisis. Discovery Projects and Early-Stage Compounds The considerable timeframe and cost of bringing a new antibiotic to market have stimulated interest in identifying compounds that have already progressed through early stages or that possess characteristics or strengths complementing existing antibiotics. Potential sources of additional scaffolds include alternative screening methods, commercial libraries of existing approved medicines, compounds from academic institutions (including compounds with internal Pharmacopeia classifications), molecules from natural-product repositories with no history of bacteriological testing, and annotated synthetic collections that specify exact chemical structures and physicochemical properties. Alternative screening methods include actinobacterial consortia mixed with Gram-negative pathogens that produce low-nutrient conditions; modulators of known targets; evolutionary solutions wherein enrichment conditions force the bacteria to acquire resistance and the compounds that grant resistance are rapidly identified; and chemical biology, which uses smaller, focused libraries to acceptivity recognizable natural product targets (Mantravadi et al., 2019). As academic libraries grow, the need for alternative tracking methods continues to escalate. Much effort focuses on high-content or label-free screening technologies. Miniaturized multiplex viability assays that reflect target modulation without requiring label additions are desirable. The use of translation-inhibitor arrays has succeeded in inhibition optimization and analysis of off-target and target-specific interactions; however, most compounds in extensive libraries lack accompanying bioactivity data. Many aminoglycosides exhibit sigma-70-specific RNA-polymerase modulation, prioritizing activities needing to evade this inhibition. Broad-screening approaches target less-explored mechanisms. Plasma-derived molecules that inhibit bioluminescence in Gram-negative bacteria, potentially acting through signal circuits or quorum-sensing systems, underscore the significance of monitoring exploratory projects. In silico tools for hit and lead selection and optimization provide another avenue for addressing developmental woes (Gajdács, 2019). Computational analyses can expedite experimental efforts by narrowing the scope of in vitro evaluations or checking target complementarity for particular actinomycetes. Historical data on combinations of hit compounds aiding lead identification, elucidating target pathways and elucidating desirable physicochemical properties expedite initial stages. Various HIV-1 inhibitors and related scaffolds with weak anticancer-potential against Gram-negative species, expanded by academic delivery and approved antibacterial terminologies, highlight the interconnectivity of these species and indicate alternative biological pathways. General Characteristics of Successful Antibiotics Novel pathways emerge to counter the increasing emergence of antibiotic resistance. The combination of bacteria-specific scaffolds and disease-discriminating chemical properties boosts both the classical utility of old antibiotics and the evolution of the search for novel scaffolds. Essential compounds should fulfil a broad spectrum of necessary characteristics tailored to their removal to prevent inhalation obstacles in the search for broad-spectrum agents (P Coussens et al., 2018).
Antibiotic resistance crisis, novel antimicrobial development, appropriate antibiotic stewardship, prescription guidelines, infection control, drug development challenges, public health strategy.
THE ROLE OF SONOGRAPHY AND NEUROPHYSIOLOGY IN HIGH-RISK PREGNANCY MONITORING: A CROSS-SECTIONAL ANALYSIS
High-risk pregnancies are at increased risk of fetal complications due to pre-existing maternal conditions or pregnancy-induced disorders. To promptly identify affected pregnancies, timely neurophysiological assessment of fetuses might assist clinical decision-making based on sonographic findings (J. van der Knoop et al., 2020). Since the combined use of sonography and neurophysiology remains insufficiently studied, this work aims to interrogate how imaging and neonatal electrocardiography converge in clinical practice for longitudinal and transitory high-risk pregnancies, and to explore the effects of anatomical abnormalities and Doppler indices on neonate- and infant-related parameters using ingredients and severe fetal growth restrictions as mediators. A cross-sectional survey examining imaging and neurophysiological assessment was conducted at two healthcare facilities in August–September 2022. Pregnant women were recruited at any point during gestation, provided they met inclusion criteria, and invited to undergo a complete set of sonographic imaging and simultaneous recording of fetal and maternal cardiac activity. Following data acquisition, multidisciplinary teams analysed the various components of each examination to identify concordance among pregnancy-related anomalies, assess the criticality of abnormal sonographic findings for monitoring schedules, and establish the influence of monovariate and bivariable factors on perinatal outcomes. The findings reveal the contribution of physiological variables originating from sonography and neurophysiology to high-risk pregnancies as an illustration of densely populated clinical focus spaces.
High-risk pregnancy; Neurophysiology; Sonography; Monitoring; Fetus; Autonomy
Salman Fahad Aldawsari, Zakaria Sadiq Salman bohassan, Zainab Ali Abdullah Alherz, Hanan Mohammed Ali hazazy and Latifa Rasheed Alkhwaitem
IMPACT OF THE COVID-19 PANDEMIC ON COLLABORATION BETWEEN RADIOLOGY TECHNOLOGISTS AND LABORATORY TEAMS: A RETROSPECTIVE ANALYSIS
Collaboration is deemed crucial to producing timely results, which is vital for high-quality patient care delivery (Cho et al., 2020). Laboratories worldwide have introduced lockdowns or imposed other restrictions to maintain social distances. These measures have disrupted routine procedural workflows in the laboratory. Radiology departments are expected to exhibit augmented collaboration with laboratories to ensure regulatory compliance and maintain the standard of care. Though interdepartmental collaboration has gained attention before the pandemic, little progress has been made in studying topics. A retrospective study was conducted to assess variables representing collaboration between radiology technologists and laboratory teams before and during the pandemic. The study aimed to examine changes in collaboration concerning three variables: communication frequency, turnaround time, and error rate.
Collaboration; Interdepartmental; Laboratory; Radiology; COVID-19.
Abdullah Mohammed Abdullah Alasmari, Ayidh Mohammed Alotaibi, Alanoud Khalf Alshammari, Saud Abdullah Bashir Al-Anezi, Bandar Saad Alaftan, Naif ali alqahtani, Norah ALragi and Sami GOMAA Alanazi
LEVERAGING INTELLECTUAL CAPITAL TO ENHANCE EMPLOYEES INNOVATIVE PERFORMANCE IN RURAL TOURISM ENTERPRISES: EMPIRICAL EVIDENCE FROM VILLAGE-OWNED ENTERPRISES (BUMDES) IN INDONESIA
This study aims to examine the effect of intellectual capital (IC) on employees’ innovative performance (IP) in tourism-sector Village-Owned Enterprises (BUMDes) in Indonesia, with knowledge management (KM) as a mediating variable. Addressing a gap in previous research, this study focuses specifically on BUMDes in Indonesia, which remain relatively underexplored in the context of the relationship between IC and IP. A quantitative survey method was employed by distributing structured questionnaires to permanent managerial-level employees in tourism-sector BUMDes in Lebak Regency, Indonesia. Out of 500 distributed questionnaires, 233 valid responses were obtained and subsequently analyzed using Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) with the assistance of IBM SPSS Amos 22. Control variables such as age, educational level, managerial position, and work experience were considered to minimize potential bias. The findings reveal that IC has a positive and significant effect on both KM and IP. Furthermore, KM was found to significantly mediate the relationship between IC and IP. All four proposed hypotheses were supported, including both direct and indirect effects. These results align with the Resource-Based View (RBV) and Knowledge-Based View (KBV) theories, underscoring the importance of managing intellectual and knowledge resources to enhance employees' innovative performance in BUMDes. This study contributes to the theoretical development of IC, KM, and IP in the context of rural tourism enterprises in developing countries, particularly Indonesia. It represents one of the first empirical studies to apply an integrated IC–KM–IP model within the BUMDes context, offering valuable insights for researchers, practitioners, and policymakers in promoting sustainable innovation and improving village-based organizational performance.
Intellectual Capital, Knowledge Management, Innovative Performance, Village-Owned Enterprises (BUMDes), Rural Tourism, Resource-Based View, Knowledge-Based View, Indonesia.
Ahmad, Rd. Tuty Sariwulan, Sri Indah Nikensari
ELECTRONIC USING PUBLIC SERVICE INNOVATION IN MEDICAL RECORDS AT SAYANG AREA PUBLIC HOSPITAL CIANJUR DISTRICT
This research aims to analyze the implementation and effectiveness of electronic-based public service innovations in medical records at Sayang Area Public Hospital, Cianjur District. The shift from manual to electronic medical record systems is expected to improve service quality, accuracy, and efficiency in healthcare administration. Using a qualitative descriptive method, data were collected through interviews, observations, and documentation. The research findings indicate that the implementation of Electronic Medical Records (EMR) at RSUD Sayang, Cianjur Regency, represents a public service innovation that positively impacts the efficiency and accuracy of patient data. This innovation is considered compatible with the needs of modern healthcare services, although it still requires adjustments in work culture and improvement in human resource competencies. The main challenges lie in the system’s complexity and the limited information technology infrastructure. However, the gradual trial process has facilitated adaptation, and the positive effects of EMR are becoming visible, particularly in terms of service speed and quality. This study also identifies a novelty aspect by integrating the dimensions of spirituality, responsibility, and synergy, as well as strengthening the initiative through the service motto: “Doctors, Nurses, and Midwives Ready to Serve Quickly – COURTEOUS AND FAST,” which supports the effectiveness of EMR implementation within the hospital environment.
Public Service Innovation, Electronic Medical Records, Hospital Administration, Sayang Hospital, Health Information Systems.
Aang Anwar Amin, Kamal Alamsyah, Ummu Salamah
THE QUINTUPLE HELIX STRATEGY FOR ENHANCING WORKFORCE COMPETENCY IN SUMEDANG REGENCY
Enhancing workforce competence has become a strategic priority in addressing the challenges of globalization and the increasingly dynamic demands of the job market. This research aims to analyze the obstacles and formulate effective strategies to improve workforce competence in Indonesia through the Quintuple Helix approach, which emphasizes synergy among five key actors: government, academia, industry, civil society, and the environment. The findings reveal that although various training and development programs have been initiated, significant internal and external barriers remain. These include a lack of coordination among stakeholders, sectoral egos, and outdated training methods that fail to meet current market needs. The Quintuple Helix model offers a strategic solution by promoting cross-sector collaboration to build an adaptive, relevant, and sustainable training ecosystem. Active public participation and the integration of sustainability into training curricula are also identified as crucial factors. These elements help prepare a workforce that is not only technically proficient but also socially and environmentally conscious. Involving all stakeholders ensures that training programs are responsive to real-world challenges and aligned with long-term development goals. This study concludes that improving workforce competence is not solely the responsibility of the government. Rather, it requires a collective effort from all segments of society to develop a high-quality, competitive, and resilient workforce. Through the Quintuple Helix approach, Indonesia can foster inclusive and sustainable human capital development that meets both current and future labor market demands.
Competence Force Work, Quintuple Helix, Training Work, Synergy, Collaboration Cross Sector.
Irma Dewi Agustin, Soleh Suryadi, Ali Anwar Yusuf
LEGAL ENVIRONMENT OF BUSINESS AND MANAGEMENT
The legal environment of business and management encompasses the framework of laws, regulations, and judicial principles that govern business operations and organizational decision-making. Understanding this environment is essential for managers, entrepreneurs, and policymakers, as it directly impacts strategic planning, risk management, corporate governance, and ethical compliance. This study examines key domains relevant to business, including contract law, corporate law, labor and employment law, consumer protection, intellectual property rights, and environmental regulations. It also explores the interplay between national legislation and international legal standards, emphasizing the role of legal compliance in fostering sustainable and responsible business practices. The analysis highlights how proactive legal awareness can mitigate, enhance organizational efficiency, and strengthen stakeholder trust. By integrating legal insights with managerial strategies, this research underscores the importance of a robust legal foundation in achieving business objectives and ensuring long-term organizational success.
Business Law, Corporate Governance, Legal Compliance, Contract Law, Intellectual Property Rights, Labor and Employment Law, Consumer Protection, Regulatory Framework, Risk Management, Ethical Business Practices.
Dr. Anant D. Chinchure , Dr Jagadish. S. Biradar , Dr. Aparna J. Shinde
CHALLENGES IN COORDINATING CARE ACROSS MULTIPLE SPECIALTIES
Health systems increasingly orient toward multispecialty care delivery, yet coordination across specialties remains underappreciated relative to integration among primary care, behavioral health, and other generalist roles. Care coordination improves quality and safety, addresses unmet needs and redundancy, and aligns actions with patient goals (Doessing & Burau, 2015). Patients with complex conditions often seek attention from multiple specialists, making an orderly, collaborative approach imperative to outcomes and experience. Stakeholders across settings face overlapping challenges in coordinating care involving multiple specialties. Barriers stem from technology and information-sharing, clinical and communication, and conceptual and policy issues (Ivanov, 2020). Technologies have the power to facilitate or hinder coordination, yet many care processes occur outside formal systems. Coordination problems arise when a single provider lacks the capacity or authority to address all patient needs. Multispecialty coordination has additional dimensions, with second opinions and team-based care introducing distinct frictions and requiring unique workflows and accountability .
Care coordination, multidisciplinary care, communication gaps, care fragmentation, patient handoffs, interoperability, treatment delays, role ambiguity.
Bandar Abdullah Jaber Zarbah1*, Eman Ahmed Ealshreef2, Fedhah Alshalawi3, Ibtihal Abdullah Tahashi4 ,Waad Abdullah Rihan Al-Rihan5, Amirah Jaber Hazazi6 Fahad Saleh Ali Alharthi7, Ghalib Khalid Omar8 and Mohammed Deyab A Alanazi9
THE ROLE OF SPECIALISTS IN COMBATING EMERGING INFECTIOUS DISEASES
Emerging infectious diseases represent a significant global public health burden, not only due to the morbidity and mortality of the infections but also because of their socioeconomic impacts. Moreover, the evolution of microbial properties that result in increased virulence and the emergence of resistance to anti-microbial drugs further complicate control efforts (W. Parkes et al., 2005). Specialists across many disciplines have extensive knowledge of these diseases and play a crucial role in their management. The field of emerging infectious diseases is broad and encompasses multiple streams of specialists. Each specialist contributes unique expertise and insights to address the complex challenges posed by emerging infections. Epidemiologists play a pivotal role in disease surveillance and data analysis, providing critical information to guide public health interventions (Burdet et al., 2018). Microbiologists are essential for pathogen identification and characterization, employing techniques such as genome sequencing and proteomics that underpin diagnostic and control strategies. Public health officials translate scientific findings into policies and programs, facilitate community engagement, and coordinate response activities. Veterinarians contribute through their focus on zoonotic and vector-borne diseases, aligning human and animal health initiatives within the One Health framework. Infectious disease physicians bridge research and practice by managing patient care and informing treatment protocols. Specialists do not operate in isolation but rather constitute an interdisciplinary framework that ensures the efficient operation of programs tackling emerging infections. With a comprehensive pool of expertise, models of emerging infectious diseases can be developed and utilized to address challenges on the front lines of disease transmission. This integrated approach underscores the essential contribution of specialists in understanding and containing emerging infectious diseases.
Specialists, infectious diseases, outbreak response, public health, epidemiology, prevention, healthcare, containment.
Bassam Neheir Alanazi, Omar Mohammed Alanazi , Yazeed Mohammed Alghareeb, Mohammed Zeyad Aljuhani, Mohmmad Fawaz Alanazi, Abdulelah Ali Mohamed Khawaji, Mohammed Adnan Obaid and Abdulaziz Mohammed Alkhathran and Sarah Saad Bin Drehim
THE IMPACT OF NURSE-PATIENT RATIOS ON QUALITY OF CARE
Safe nurse-patient ratios influence quality of care. Research across various institutions documents a robust connection between these ratios and patient outcomes, impacts). Level of care, remote oversight, and organizational constraints moderate effectiveness of nurse-patient ratios. Nurse-patient ratio standards present a feasible, cost-effective strategy to safeguard quality of care. An extensive body of research documents strong links between nurse-patient ratios, workload, and patient outcomes in acute-care settings (D McHugh et al., 2021). These connections underlie decades of policy debate around minimum nurse-patient ratios and their implementation. Historical developments, then contemporary evidence linking ratios to patient outcomes, serve as foundational context for the ensuing discussion of mechanisms.
Abdullatif Neheir Alanazi, Adel Soliman Alhejji, Yousef Abdullah owemer,Bassam Neheir Alanazi and Nawaf Khalid Bin shannan
ENHANCING MEDICATION SAFETY THROUGH NURSE-PHARMACIST COLLABORATION
Patient safety remains at the forefront of healthcare concerns across the world. Complex healthcare environments demand constant vigilance to prevent adverse outcomes. Medication safety constitutes a critical aspect of patient care. Since nurses handle the administration of most prescribed medications, the responsibility largely falls to them. Moreover, irregularities in nursing practices account for nearly 44% as a leading contributor to medication errors (Elena Herrera, 2015). Pharmacists complement these efforts by providing expertise and oversight. The two professions combine to play a pivotal role in patient safety. In the past, the professions often worked independently. More recently, collaboration has become a priority among healthcare institutions. Notebook pages iterate findings from extensive bibliographic consultations elucidating the importance, benefits, and impediments of cooperative efforts, along with practical strategies to enhance teamwork. Collaborative partnerships generate positive outcomes for patients while ensuring safety. Integration remains vital to the comprehensive delivery of patient-centered care.
nurse-pharmacist collaboration, medication safety, patient outcomes, interprofessional education, communication, healthcare integration, patient-centred care, technology
Hatim Saad Alghamdi and Bandar Mohammad Jaber Alqarni
ADDRESSING VACCINE HESITANCY: STRATEGIES FOR IMPROVING PUBLIC TRUSTAn Integrated Approach to Building Confidence in Immunization
Vaccine hesitancy poses a significant challenge to public health initiatives, often undermining efforts to control disease outbreaks and prolonging health crises (W. Strully et al., 2021). Trust in vaccines, healthcare institutions, and public health authorities is shaped by a range of sociodemographic and cultural factors, yet many individuals remain open to vaccination (Enria et al., 2021). To restore public trust and increase vaccine uptake, a comprehensive strategy that incorporates communication, policy, and healthcare interventions is essential. Robust health campaigns have played a pivotal role, involving substantial investment in information dissemination and widespread community engagement. These efforts have been instrumental in curbing misinformation and correcting misconceptions. Successful vaccine campaigns can be organized into three core components: communication strategies, policy and structural interventions, and the roles of healthcare systems. Communication Strategies Vaccine hesitancy is a global phenomenon, with varying levels of trust in vaccines and related public health entities across different countries, regions, and demographic groups. Effective risk communication hinges on clarity, transparency, and credibility. By delivering straightforward messages, aligning information with audience values, and minimizing technical jargon, communicators can reduce confusion and prevent further erosion of trust. Simplifying the language and framing information to match the audience's perspectives help ensure that vaccine-related messages are both accessible and persuasive. Policy and Structural Interventions Practical barriers—collectively termed accessibility interventions—significantly influence an individual’s willingness to pursue vaccination. Addressing these barriers involves implementing straightforward measures to make health information and vaccines more accessible. These interventions should focus on eliminating obstacles that hinder the public from obtaining vaccines and related information, ensuring equitable access for all population segments. Healthcare System Roles Healthcare providers play a critical role in vaccine education and uptake. Engaging patients in conversations about vaccines during healthcare visits, regardless of their initial stance on vaccination, can significantly improve acceptance. Providers should be equipped and encouraged to address vaccine concerns, offer information, and support patient decision-making, particularly for those who are hesitant or initially refuse vaccination.
Vaccine hesitancy, public trust, communication strategies, education programs, misinformation, community engagement, cultural sensitivity, vaccination uptake.
Abeer Hamad AlRashid, Abdulrahim Saleh Alenazi, Shaykhah Mohammed Aldosari, Raghad Mohammed Alfaqi, Eman kulaib albalawi, Nada Saddig Almaghrabi, Nawaf Abdulaziz Alenizi and Sarah Jaber Salami
DETERMINANTS OF DIGITAL HEALTHCARE ADOPTION IN MALAYSIA: A DIRECT EFFECTS ANALYSIS USING TAM, UTAUT, AND VAM FRAMEWORKS
This study explores the direct effects of perceived value, trust, and convenience on digital literacy and consumer behaviour in the adoption of digital healthcare services in Malaysia. Grounded in the Technology Acceptance Model (TAM), Unified Theory of Acceptance and Use of Technology (UTAUT), and Value-based Adoption Model (VAM), the study collected primary data from 351 respondents across urban and rural regions. Structural Equation Modelling (SEM) was employed to test the hypothesized relationships. Findings reveal that all three predictors significantly and positively influence both digital literacy and behavioural intention. Convenience emerged as the strongest determinant. These insights offer practical implications for healthcare providers, policymakers, and developers aiming to enhance digital health adoption in emerging markets.
Digital Transformation, Digital Healthcare, Consumer Behaviour, Digital Healthcare Adoption, Mobile Health, Telemedicine Platforms, Online Pharmacies, Technology Acceptance Model (TAM), Unified Theory of Acceptance, Technology (UTAUT), Value-based Adoption Model (VAM), Perceived Value, Trust, Convenience
Siow Sin Wei, Rozaini Binti Rosli, Muhamad Imam Syairozi
FLU SHOTS FOR HEALTHCARE WORKERS: SAFEGUARDING THE FRONTLINE
Healthcare workers (HCWs) constitute more than 15% of the U.S. workforce, many of whom directly interact with high-risk patients. Influenza, a widespread contagious disease causing a significant global health burden, results in the deaths of hundreds of thousands every year, yet many HCWs refuse to receive flu vaccines despite labor laws and hospital policies requiring them. HCWs who refuse the flu vaccine put themselves in harm of infection, potentially killing those they are caring for and transmitting the virus to others within the community in which they live. This paper examines the dilemma of flu vaccination refusal, advocating for adherence to policies mandating flu vaccination among healthcare personnel to protect both HCWs and their patients. Vaccination constitutes one of the most effective measures to prevent influenza among healthcare workers (HCWs) and reduce the transmission to patients. Annual vaccination serves as a critical preventive measure, protecting at-risk populations, particularly when non-pharmaceutical interventions are inadequate or cannot be implemented swiftly. Introduced in the 1940s, the influenza vaccine remains the most effective preventive strategy, offering individual protection and diminishing the risk of virus transmission from HCWs to patients. The non-live influenza vaccine, derived from inactivated virus, demonstrates no significant association with adverse effects in recipients. Influenza vaccination for HCWs is essential for both personal protection and to inhibit nosocomial infections, thereby safeguarding healthcare facilities and underscoring the priority of occupational health across all professions (Miller, 2018).
Influenza, healthcare workers, mandatory vaccination, vaccination policies, vaccine uptake, influenza transmission, patient safety, public health. Influenza is a major cause of avoidable morbidity and mortality, affecting patients, healthcare systems, and the wider community. Typical annual influenza epidemics result in approximately 3-5 million cases of severe illness and ~290,000 to 650,000 respiratory deaths worldwide. Healthcare workers (HCWs) are at heightened risk of influenza infection due to occupational exposure, and their vaccination can protect both themselves and their patients. Despite recommendations by leading public health authorities, influenza vaccination coverage for HCWs remains below recommended levels in many countries. Mandatory vaccination policies have increased vaccination coverage in several jurisdictions; delegates to the WHO’s SAGE have therefore requested an assessment of the effectiveness of mandatory HCW vaccination policies in preventing and controlling influenza transmission to inform guidelines (Miller, 2018) (Guillari et al., 2021).
Abdullatif Neheir Alanazi, Adel Soliman Alhejji, Yousef Abdullah owemer and Bassam Neheir Alanazi