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Article: Pediatric residents' perceptions of the impact of the 24-hour on-call system on their well-being and education and patient safety. A national survey.

Alsohime, Fahad M

2019 Volume 40, Issue 10, Page(s) 1040–1044

Abstract: Objectives: To examine pediatric residents' perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety.: Methods: A cross-sectional survey conducted with residents enrolled in pediatric residency ... ...

Abstract	Objectives: To examine pediatric residents' perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety. Methods: A cross-sectional survey conducted with residents enrolled in pediatric residency programs across Saudi Arabia in February 2017 at the Saudi Commission For Health Specialties, Riyadh Saudi Arabia. We designed a self-administered questionnaire that was distributed using the Saudi Commission for Health Specialties E-mail groups. A 4-point Likert-type scale was used to rank the residents' responses; and the relative importance index (RII) approach was used to analyze the relative contribution of each indicator to its main theme. Results: A total of 314 residents participated in the survey (response rate, 30%). Of these, 168 (53.6%) were females. When asked about their preferences regarding the 24-hour on-call system, 286 residents (91.1%) preferred not to continue with this system. Residents ranked several indicators that they perceived as a negative impact due to the 24-hour on-call system. The first ranked indicator was missing academic activities and elective rotations post-call (mean 3.10 [standard deviation 1.25], RII 90.94%), and the second was decreased performance and decision-making skills during night duty (mean 3.51 [standard deviation 1.0], RII 88.11%). Conclusion: We found that the 24-hour on-call system negatively impacts residents' well-being and education and patient care. Pediatric residency training programs in Saudi Arabia should consider resident duty hour reform and evaluate new on-call models to improve resident well-being and training, as well as patient care.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Humans ; Internship and Residency/organization & administration ; Internship and Residency/statistics & numerical data ; Male ; Patient Safety ; Pediatrics/education ; Personnel Staffing and Scheduling ; Saudi Arabia ; Surveys and Questionnaires ; Work Schedule Tolerance/physiology ; Work Schedule Tolerance/psychology
Language	English
Publishing date	2019-11-05
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	392302-2
ISSN	1658-3175 ; 0379-5284
ISSN (online)	1658-3175
ISSN	0379-5284
DOI	10.15537/smj.2019.10.24548
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Article ; Online: Pediatric residents’ perceptions of the impact of the 24-hour on-call system on their well-being and education and patient safety. A national survey

Fahad M. Alsohime

Saudi Medical Journal, Vol 40, Iss 10, Pp 1040-

2019 Volume 1044

Abstract: Objectives: To examine pediatric residents’ perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety. Methods: A cross-sectional survey conducted with residents enrolled in pediatric residency ... ...

Abstract	Objectives: To examine pediatric residents’ perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety. Methods: A cross-sectional survey conducted with residents enrolled in pediatric residency programs across Saudi Arabia in February 2017 at the Saudi Commission For Health Specialties, Riyadh Saudi Arabia. We designed a self-administered questionnaire that was distributed using the Saudi Commission for Health Specialties E-mail groups. A 4-point Likert-type scale was used to rank the residents’ responses; and the relative importance index (RII) approach was used to analyze the relative contribution of each indicator to its main theme. Results: A total of 314 residents participated in the survey (response rate, 30%). Of these, 168 (53.6%) were females. When asked about their preferences regarding the 24-hour on-call system, 286 residents (91.1%) preferred not to continue with this system. Residents ranked several indicators that they perceived as a negative impact due to the 24-hour on-call system. The first ranked indicator was missing academic activities and elective rotations post-call (mean 3.10 [standard deviation 1.25], RII 90.94%), and the second was decreased performance and decision-making skills during night duty (mean 3.51 [standard deviation 1.0], RII 88.11%). Conclusion: We found that the 24-hour on-call system negatively impacts residents’ well-being and education and patient care. Pediatric residency training programs in Saudi Arabia should consider resident duty hour reform and evaluate new on-call models to improve resident well-being and training, as well as patient care.
Keywords	Residency ; duty hour ; post-graduate ; work schedule tolerance ; Medicine ; R
Subject code	360
Language	English
Publishing date	2019-10-01T00:00:00Z
Publisher	Ministry of Defence and Aviation
Document type	Article ; Online
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Article: Research involvement and obstacles among trainees enrolled in a pediatric residency program in Saudi Arabia.

AlSohime, Fahad

International journal of pediatrics & adolescent medicine

2018 Volume 5, Issue 3, Page(s) 88–91

Abstract: Objective: This study aimed to investigate pediatric residents' involvement in research and their attitudes toward potential barriers to conducting research.: Methods: This cross-sectional survey was conducted in February 2017 and targeted residents ... ...

Abstract	Objective: This study aimed to investigate pediatric residents' involvement in research and their attitudes toward potential barriers to conducting research. Methods: This cross-sectional survey was conducted in February 2017 and targeted residents enrolled in the Saudi Pediatric Residency Program. An online self-administered questionnaire was designed to assess residents' involvement in different domains of scholarly activity and their perception of barriers to research. All items used a five-point Likert-type scale with response options varying depending on the question. The relative importance index (RII) approach was used to analyze the relative contribution of each indicator to its main theme. Results: A total of 314 pediatric residents agreed to complete the survey. Of these, 168 (53.5%) were female. Residents rated their involvement in all aspects of research as low. The top-ranked item was residents' participation in data collection for research (mean [standard deviation, SD] rating, 2.74 [1.3]; RII, 54.2%), followed by residents' participation in a structured literature review of a topic (mean [SD] rating, 2.6 [1.3]; RII, 52.1%). The lowest-rated items were residents' involvement in manuscript writing (mean [SD] rating, 2.3 [1.24]; RII, 46.1%) and their participation in statistical analysis (mean [SD] rating, 1.23 [1.21]; RII, 44.5%). The residents ranked the lack of dedicated time as the most significant barrier to their participation in scholarly activities (mean [SD] rating, 3.44 [1.3]; RII, 68.83%). Conversely, they ranked the lack of interest as the lowest barrier to research participation (mean [SD] rating, 2.85 [1.2]; RII, 56.96%). Conclusion: Overall, pediatric residents rated their involvement in all aspects of research as low, especially in manuscript writing and statistical analysis. These findings suggest the need to provide support for the development of a mentoring program as well as to develop a robust and longitudinal research curriculum for the pediatric residency program to encourage the involvement of trainees in research.
Language	English
Publishing date	2018-09-10
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2832064-5
ISSN	2352-6467
ISSN	2352-6467
DOI	10.1016/j.ijpam.2018.06.001
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Article ; Online: How to follow the guidelines, when the appropriate fluid is missing?

Brossier, David W / Goyer, Isabelle / Morice, Claire / Alsohime, Fahad / Mayberry, Huw F / Porcheret, Florence / Tume, Lyvonne N / Valla, Frederic V

European journal of pediatrics

2024

Abstract: Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when ... ...

Abstract	Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when prescribing IV-MFT in both acute and critical paediatric care. Unfortunately, the applicability of these guidelines could be called into question when a ready-to-use glucose-containing balanced isotonic fluid is not available. The main objective of this study was to describe the availability of glucose-containing balanced isotonic fluids in European and Middle Eastern paediatric acute and critical care settings. This work is an ancillary study of the survey dedicated to IV-MFT practices in the paediatric acute and critical care settings in Europe and Middle East, a cross-sectional electronic 27-item survey, emailed in April-May 2021 to paediatric critical care physicians across 34 European and Middle East countries. The survey was developed by an expert multi-professional panel within the European Society of Peadiatric and Neonatal Intensive Care (ESPNIC). Balanced isotonic fluid with glucose 5% was available for only 32/153 (21%) responders. Balanced isotonic fluid with glucose 5% was consistently available in the UK (90%) but not available in France, Greece, The Netherlands and Turkey. Conclusion: Ready-to-use isotonic balanced IV solutions containing glucose in sufficient amount exist but are inconsistently available throughout Europe. National and European Medication Safety Incentives should guarantee the availability of the most appropriate and safest IV-MFT solution for all children. What is Known: • Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. • Balanced isotonic fluid is recommended when prescribing IV-MFT in both acute and critical paediatric care. What is New: • Balanced isotonic fluid with glucose 5% is available for less than 25% of the prescribers in Europe and the Middle East. Availability of balanced isotonic fluid with glucose 5% varies from one country to another but can also be inconsistent within the same country. • Clinicians who have access to a ready-to-use balanced isotonic fluid with glucose 5% are more likely to consider its use than clinicians who do not have access to such an IV solution.
Language	English
Publishing date	2024-03-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-024-05514-6
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Article: Propranolol-induced hyperkalemia in infantile hemangioma patients: How serious is it?

Alakeel, Abduallah / Alsalman, Hanan / Alotaibi, Ghadah / Somily, Haneen / Alsohime, Fahad

Journal of family medicine and primary care

2022 Volume 11, Issue 11, Page(s) 6944–6948

Abstract: Background: Infantile hemangioma is the most frequent benign vascular tumor of infancy, which has a specific clinical history of early growth, followed by spontaneous remission. Since the fortuitous discovery of propranolol's efficacy in 2008, the ... ...

Abstract	Background: Infantile hemangioma is the most frequent benign vascular tumor of infancy, which has a specific clinical history of early growth, followed by spontaneous remission. Since the fortuitous discovery of propranolol's efficacy in 2008, the management of infantile hemangioma has been quickly developing. Methods: This study is a retrospective cohort study. Electronic search in the patient's registry of King Khalid University Hospital, Riyadh, Saudi Arabia, was performed using the keywords hemangioma, haemangioma, infantile hemangioma, and vascular tumors. The search revealed a total of 101 subjects for which 56 were included and 45 were excluded. Results: A total of 56 patients with infantile hemangioma were evaluated in this study. The majority were females. The F: M ratio is 3.4:1. The highest percentage of the patients was delivered by the elective cesarian section, that is, 23 (41.1%), followed by spontaneous vaginal delivery, that is, 19 (33.9%). Full-term patients were 27 (48%), whereas the pre-term patients were 21 (37%). The total number of patients who developed hyperkalemia while on propranolol was 12 (31%). There was no statistically significant difference (P > 0.05) between patients who developed hyperkalemia and patients who did not develop hyperkalemia in terms of gender, gestational age, mode of delivery, size and location of hemangioma, or concomitant topical timolol use. Conclusion: Hyperkalemia is benign and transient, although solid conclusive opinions cannot be drawn because of the small sample size and the retrospective nature of the study.
Language	English
Publishing date	2022-12-16
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_658_22
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Article ; Online: Correction to: Intravenous maintenance fluid therapy practice in the pediatric acute and critical care settings: a European and Middle Eastern survey.

Morice, Claire / Alsohime, Fahad / Mayberry, Huw / Tume, Lyvonne N / Brossier, David / Valla, Frederic V

European journal of pediatrics

2022 Volume 181, Issue 8, Page(s) 3173

Language	English
Publishing date	2022-06-06
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-022-04513-9
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Article: Technical Aspects of Intensive Care Unit Management: A Single-Center Experience at a Tertiary Academic Hospital.

Alsohime, Fahad / Temsah, Mohamad-Hani / Al-Eyadhy, Ayman / Ghulman, Sanaa / Mosleh, Haytam / Alsohime, Omar

Journal of multidisciplinary healthcare

2021 Volume 14, Page(s) 869–875

Abstract: Purpose: Special technical issues associated with the function and maintenance of medical devices arise in intensive care units (ICUs). This study explored the level of comfort of ICU staff in dealing with selected equipment, the factors that are ... ...

Abstract	Purpose: Special technical issues associated with the function and maintenance of medical devices arise in intensive care units (ICUs). This study explored the level of comfort of ICU staff in dealing with selected equipment, the factors that are associated with the staff's ease of adaptation to new technologies, and the role of technical support staff. Patients and methods: This is a single-center cross-sectional questionnaire-based survey that was conducted in February 2018 and targeted nurses working in the ICUs of King Saud University Medical City in Riyadh, Saudi Arabia. Results: Among the 297 nurses who completed the survey, almost all of the respondents (99.3%) were aware of the ICU equipment preventive maintenance program. Most of the nurses had received training on how to use infusion pumps (96.2%), cardiac monitoring systems (78.0%), and cardiac defibrillation devices (73.9%). Sixty nurses (20.2%) indicated that at least one super user was available for at least one device. About half of the staff reported one device whose user manual was available. Most nurses reported having no resources regarding updates on medical devices. Conclusion: Our findings revealed an alarming need to address technical issues related to medical devices used in the ICU and to design a framework for the safe operation of medical devices based on international practices. It is necessary to empower the role of the super user and medical device clinical educator as well as to optimize communication between the national regulatory body of medical devices and healthcare providers, especially those working in acute care areas.
Language	English
Publishing date	2021-04-20
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2453343-9
ISSN	1178-2390
ISSN	1178-2390
DOI	10.2147/JMDH.S294905
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Article: 2020 Update to Spinal Muscular Atrophy Management in Saudi Arabia.

Bashiri, Fahad A / Temsah, Mohamad-Hani / Hundallah, Khalid / Alsohime, Fahad / AlRuthia, Yazed

Frontiers in pediatrics

2021 Volume 9, Page(s) 684134

Abstract: Novel therapeutic strategies have shown some promise in treating spinal muscular atrophy (SMA). However, the outcomes and acceptance of these new strategies are yet to be explored. We aimed to investigate physicians' opinions and perceptions toward ... ...

Abstract	Novel therapeutic strategies have shown some promise in treating spinal muscular atrophy (SMA). However, the outcomes and acceptance of these new strategies are yet to be explored. We aimed to investigate physicians' opinions and perceptions toward management strategies of SMA across Saudi Arabia. This is a cross-sectional survey using a self-administered, structured questionnaire sent to physicians who care for SMA patients during the Saudi Pediatric Neurology Society annual conference. A total of 72 clinicians of different neurological subspecialties were included. 48.6% prescribed nusinersen to their patients, with 39% of them having patients started on nusinersen. Though, 8.3% prescribed onasemnogene abeparvovec for 1-3 patients, while none of their patients started on the treatment. 64.3% stated that the only treatment available for SMA in their settings is supportive care. Around 69.4% described having a moderate to high knowledge on SMA gene therapy, and 79.2% would recommend it. 48.6% confirmed they would prescribe gene therapy at the age of 6 months, and 78.3% would prescribe it for type-I SMA. Pediatric neurologists are receptive to novel and innovative therapies for SMA in Saudi Arabia. However, the high treatment acquisition cost, strict regulations, logistical issues, and budget constraints delay their adoption and implementation.
Language	English
Publishing date	2021-05-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2021.684134
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Article ; Online: Intravenous maintenance fluid therapy practice in the pediatric acute and critical care settings: a European and Middle Eastern survey.

Morice, Claire / Alsohime, Fahad / Mayberry, Huw / Tume, Lyvonne N / Brossier, David / Valla, Frederic V

European journal of pediatrics

2022 Volume 181, Issue 8, Page(s) 3163–3172

Abstract: The ideal fluid for intravenous maintenance fluid therapy (IV-MFT) in acutely and critically ill children is controversial, and evidence-based clinical practice guidelines are lacking and current prescribing practices remain unknown. We aimed to describe ...

Abstract	The ideal fluid for intravenous maintenance fluid therapy (IV-MFT) in acutely and critically ill children is controversial, and evidence-based clinical practice guidelines are lacking and current prescribing practices remain unknown. We aimed to describe the current practices in prescribing IV-MFT in the context of acute and critically ill children with regard to the amount, tonicity, composition, use of balanced fluids, and prescribing strategies in various clinical contexts. A cross-sectional electronic 27-item survey was emailed in April-May 2021 to pediatric critical care physicians across European and Middle East countries. The survey instrument was developed by an expert multi-professional panel within the European Society of Pediatric and Neonatal Intensive Care (ESPNIC). A total of 154 respondents from 35 European and Middle East countries participated (response rate 64%). Respondents were physicians in charge of acute or critically ill children. All respondents indicated they routinely use a predefined formula to prescribe the amount of IV-MFT and considered fluid balance monitoring very important in the management of acute and critically ill children. The use of balanced solution was preferred if there were altered serum sodium and chloride levels or metabolic acidosis. Just under half (42%, 65/153) of respondents believed balanced solutions should always be used. Respondents considered the use of isotonic IV solutions as important for acute and critically ill children. In terms of the indication and the composition of IV-MFT prescribed, responses were heterogeneous among centers. Almost 70% (107/154) respondents believed there was a gap between current practice and what they considered ideal IV-MFT due to a lack of guidelines and inadequate training of healthcare professionals. Conclusions: Our study showed considerable variability in clinical prescribing practice of IV-MFT in acute pediatric settings across Europe and the Middle East. There is an urgent need to develop evidence-based guidelines for IV-MFT prescription in acute and critically ill children. What is Known: • The administration of maintenance intravenous fluid therapy is a standard of care for a lot of hospitalized children • Maintenance intravenous fluid therapy prescriptions are often based on Holliday and Segar's historical guidelines even if this practice has been associated with several complications. What is New: • This study provided information on the prescribing practice regarding fluid restriction, fluid tonicity, and balance. • This study showed considerable variability in clinical prescribing practice of intravenous maintenance fluid therapy across Europe and the Middle East.
MeSH term(s)	Child ; Critical Care ; Critical Illness/therapy ; Cross-Sectional Studies ; Fluid Therapy ; Humans ; Infant, Newborn ; Infusions, Intravenous ; Isotonic Solutions ; Surveys and Questionnaires
Chemical Substances	Isotonic Solutions
Language	English
Publishing date	2022-05-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-022-04467-y
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Article ; Online: Implications of mosaicism in variant interpretation: A case of a de novo homozygous NF1 variant.

Alghamdi, Malak / Monies, Dorota / Alsohime, Fahad / Temsah, Hani / Almodaihsh, Fahad / Aldawasri, Mana / Alsultan, Abdulrahman / Alkuraya, Fowzan S

European journal of medical genetics

2021 Volume 64, Issue 7, Page(s) 104236

Abstract: Neurofibromatosis type 1 is a common multisystem autosomal dominant syndrome caused by pathogenic heterozygous variants in the neurofibromin gene (NF1). It is associated with a substantially increased cancer risk. Mosaicism for NF1 has been clinically ... ...

Abstract	Neurofibromatosis type 1 is a common multisystem autosomal dominant syndrome caused by pathogenic heterozygous variants in the neurofibromin gene (NF1). It is associated with a substantially increased cancer risk. Mosaicism for NF1 has been clinically well-established for "second hit" variants in skin lesions and tumor tissues. Here, we report on a 3-month-old boy with multiple café au lait macules (CAMs) and juvenile myelomonocytic leukemia (JMML) who was found to carry a previously established pathogenic NF1 variant (c.586+5G>A), as revealed by whole-exome sequencing. Surprisingly, however, this variant was detected in the homozygous state in the patient and was absent in the parents and siblings. Deep sequencing of this variant using blood, buccal swabs and skin samples was performed. As expected for an NF1 gene mutation promoting JMML, the variant was detected in 90.6% of the blood DNA reads, in sharp contrast to the mere 5% and 0.74% of reads in the saliva- and skin fibroblast-derived DNA, respectively. Our analysis, therefore, confirmed postzygotic origin of the variant followed by a mitotic event resulting in its homozygosity, although we could not differentiate between the possibilities of a gene conversion and mitotic crossover. Apparently de novo homozygous variants should trigger a careful investigation into mosaicism to achieve accurate interpretation.
MeSH term(s)	Bone Marrow Cells/metabolism ; Cafe-au-Lait Spots/genetics ; Cafe-au-Lait Spots/pathology ; Cells, Cultured ; Crossing Over, Genetic ; Fibroblasts/metabolism ; Gene Conversion ; Genetic Testing/methods ; Homozygote ; Humans ; Infant ; Leukemia, Myelomonocytic, Juvenile/genetics ; Leukemia, Myelomonocytic, Juvenile/pathology ; Male ; Mitosis ; Mosaicism ; Mutation ; Neurofibromin 1/genetics ; Pedigree
Chemical Substances	NF1 protein, human ; Neurofibromin 1
Language	English
Publishing date	2021-05-20
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	2184135-4
ISSN	1878-0849 ; 1769-7212
ISSN (online)	1878-0849
ISSN	1769-7212
DOI	10.1016/j.ejmg.2021.104236
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