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ASSESSMENT OF ICU NURSES’ KNOWLEDGE, COMPLIANCE AND BARRIERS TOWARD EVIDENCE-BASED GUIDELINES FOR VENTILATOR-ASSOCIATED PNEUMONIA PREVENTION IN PALESTINE: A CROSS-SECTIONAL STUDY
(An-Najah National University, 2026-04-15) Janem, Salsabeel
Background: In critical care units (ICUs), tracheal intubation and invasive mechanical ventilation (MV) are essential life-saving treatments for a considerable proportion of patients with severe illnesses. MV is associated with many complications, one of which is ventilator-associated pneumonia (VAP). Prevention of VAP is achieved through both non-pharmacological and pharmacological methods. Non-pharmacological measures include a set of evidence-based guidelines (EBGs) for preventing VAP. The majority of VAP prevention methods are implemented by nurses, who play a crucial role in respiratory care. Aim of study: To determine ICU nurses' knowledge and compliance with evidence-based guidelines for the prevention of VAP in hospitals in Palestine. The research also aimed to identify the primary barriers preventing ICU nurses from using EBGs to reduce VAP. Methods: A cross-sectional study was conducted by distributing a self-administered questionnaire to 240 ICU nurses in West Bank Hospitals of the Palestinian Ministry of Health and private hospitals, across three geographical sections: north, middle, and south, during March and May 2025. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 26. A P-value <0.05 was considered statistically significant. Result: This study found that a high percentage of nurses in the ICU have a good knowledge about EBGs for the prevention of VAP, which 80.4% of nurses having a good knowledge score, it was found that 68.3% of nurses have a high compliance with EBGs. However, the study found that there is no significant association between nurses' knowledge and compliance level ( p value=0.126). On the other hand, the study showed that ICU types are associated with nurses' knowledge and compliance levels regarding EBGs (p values = 0.010, 0.025, respectively). In addition to ICU type, prior training on EBGs also affects nurses' compliance level (p value=0.004). The most significant barriers that may affect nurses’ response to EBGs were a shortage of nursing staff, a limited hospital budget, a lack of ongoing education on EBGs to prevent VAP, a lack of university efforts to educate students about EBGs, and the unavailability of resources. Conclusion: nurses working in the ICU demonstrated good knowledge and high compliance with EBGs to protect patients in MV from VAP. Also, we conclude that there is no significant association between knowledge level and nurses' compliance with EBGs. Keywords: ventilated associated pneumonia, critical care unit, evidence-based guidelines, mechanical ventilator.
METFORMIN ANTIBACTERIAL AND ANTI-VIRULENCE ACTIVITIES AGAINST HELICOBACTER PYLORI
(An-Najah National University, 2026-04-23) Rajab, Walaa Hashem Ahmad
Introduction: Helicobacter pylori (H. pylori) infection is highly prevalent worldwide and is associated with multiple gastroduodenal pathologies, including gastric cancer. The increasing drug resistance among H. pylori limits available treatment options. To overcome this challenge, drug repurposing and the use of current medications as adjuvant therapies have emerged as a valuable alternative strategy. Metformin is a commonly prescribed anti-diabetic drug for type 2 diabetes mellitus (T2DM); it has been shown to have antibacterial properties. This study aimed to investigate metformin’s antimicrobial activity against H. pylori, its virulence factors and evaluate its potential dual synergy with each of the six antibiotics commonly used in the treatment of H. pylori infections. Methods: The antibacterial effect of metformin on H. pylori was evaluated using both clinical isolates and reference laboratory strains by detecting the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Furthermore, a checkerboard assay was conducted to assess the combined effect of metformin with six antibiotics used to treat H. pylori infections (levofloxacin, metronidazole, tetracycline, amoxicillin, rifampicin, and clarithromycin). Additionally, phenotypic evaluation of its antibiofilm and antiurease activities followed by molecular detection for a panel of virulence genes’ expression using real-time PCR. Results: Metformin showed antibacterial activity against H. pylori with MIC values ranging between 6.38 and 9.75 mM (1131-1615 µg/mL). MIC/MBC ratios and time-kill study suggested a bactericidal effect against the tested H. pylori strains. Moreover, the Fractional Inhibitory Concentration Index (FICI) values support metformin additive effect (FICI values 0.52-1.0), without synergistic or antagonistic interactions. Metformin expressed a profound biofilm suppression with comprehensive downregulation for the studied genes, marked by virB4 gene reduced expression. Conclusion: The additive effect and the bactericidal activity of metformin suggest a potential clinical relevance for diabetic patients already receiving this medication. Furthermore, the observed anti-virulence activity may potentiate metformin’s role as an adjuvant. However, comprehensive studies are needed to further evaluate the safety and efficacy using in vivo, preclinical, and clinical trials.
THE IMPACT OF JOB SATISFACTION ON RETAINING HEALTH CARE WORKERS IN HOSPITALS - WEST BANK – PALESTINE
(An-Najah National University, 2026-04-02) Daraghmeh, Karima Saleh Suliman
Healthcare systems face persistent workforce shortages, and retaining healthcare workers is a priority for the continuance of a healthcare facility, quality, and organizational performance. This study examined the association between overall job satisfaction and retention (intent to stay) among healthcare workers employed in private hospitals in Nablus, Palestine. A cross sectional survey was conducted between August–September 2025 across five private hospitals in Nablus, using paper-based, anonymous questionnaires administered during on-duty hours. Job satisfaction was measured using Spector’s 36-item Job Satisfaction Survey (JSS; 1–6 scale), and retention was measured using McCain’s 5-item Intent-to-Stay (ITS; 1–5 scale).Data were analyzed in SPSS using descriptive statistics, one-sample t-tests against neutral midpoints, group comparisons (t-tests/ANOVA), Pearson correlations, and a multivariable general linear model adjusting for demographics. A total of 251 healthcare workers were valid for participation, with broad departmental representation and a predominantly young workforce. Overall job satisfaction was near-neutral (JSS mean = 3.53, SD = 0.53) and did not differ significantly from the neutral midpoint (3.5), while intent to stay was slightly below-neutral (ITS mean = 2.89, SD = 0.90) and did not differ significantly from its midpoint (3.0). Job satisfaction correlated positively with intent to stay (r = .384, p < .001).In the multivariable model, job satisfaction remained a strong independent predictor of intent to stay (B = 0.649, SE = 0.110, p < .001), explaining substantial variance (R² = .432; adjusted R² = .272). Facet patterns suggested relatively higher satisfaction with supervision and nature of work, and lower satisfaction with pay and benefits. In conclusion, even in an overall neutral satisfaction workplace, job satisfaction is a meaningful and independent motivation for healthcare workers’ intention to remain in Nablus private hospitals. Retention strategies should prioritize strengthening supervisory practices, improving communication and work design, and addressing structural reward domains (pay/benefits/recognition), with the attention to scheduling patterns associated with staying intentions.
ENERGY MANAGEMENT IN THE HEALTH SECTOR: A CASE STUDY OF NABLUS SPECIALTY HOSPITAL
(An-Najah National University, 2026-05-14) Romaysa Duridi
This study is about finding ways to save energy in a big hospital, in Nablus, Palestine. The hospital uses a lot of energy every day. To see where the hospital can save energy, we did a full energy audit to understand how the hospital uses energy in day-to-day operation and to identify where the main losses and inefficiencies happen. RET Screen Expert was used as the main tool to assess the current situation and to compare improvement options. The study suggests a number of practical measures, including the installation of a solar water heating system, the upgrade of the lighting to more efficient technology, the enhancement of the building's insulation, the enhancement of HVAC efficiency through improved performance tuning and regular maintenance, and the installation of a photovoltaic (PV) system above the parking area to generate a portion of the hospital's electricity demand, all of which are based on the audit findings. The environmental, financial, and energy-saving impacts of the proposed actions were examined in this study. The results showed that the implementation of the energy audit measurements could reduce energy consumption by approximately 30%, equivalent to around 379,050 kWh/year. In addition, annual cost savings of about USD 115,921 and a reduction of approximately 102 tons of CO₂ emissions per year could be achieved. The results also indicated that hospital operating costs, pollution levels, and energy consumption could be reduced simultaneously. It should be emphasized that the most effective energy-saving solutions are those that provide both environmental and financial benefits. Therefore, healthcare facility decision-makers may be encouraged to adopt such measures, as they can contribute to improving energy performance while reducing operational costs and environmental impacts.
بنية الإبداع في زمن الحرب كتابة خلف الخطوط يوميات الحرب على غزة أنموذجًا
(جامعة النجاح الوطنية, 2026-04-06) كوثر سعيد محمد عواد
تناولت هذه الدراسة بنية الإبداع في زمن الحرب، متخذةً من كتاب "كتابة خلف الخطوط، يوميات الحرب على غزة" أنموذجًا، بوصف الحرب عاملًا محفّزًا على توليد الإبداع لدى الكُتّاب من رحم المعاناة، على الرغم من آثارها المأساوية. وقد قامت الدراسة بتحليل النصوص الأدبية الواردة في الكتاب بما تحمله من بنى إبداعية سردية، مقدِّمةً رؤية حيّة للواقع الغزّي وما يعتريه من آلام متنوعة، وقلق وجودي، وتهديد دائم بالفناء، ما يجعل هذه النصوص عملًا فنيًا عميقًا يوجّه القارئ إلى حياة الغزّي وصراعاته الداخلية المستمرة، وذلك بالاعتماد على المنهج الوصفي التحليلي. تكوّنت الدراسة من ثلاثة فصول، مسبوقة بمقدمة ومذيّلة بخاتمة. وبيّنت الباحثة في المقدمة موضوع الدراسة، وأهميتها، وأسباب اختيارها، وطرحت أهم الأسئلة التي تسعى للإجابة عنها. تناول الفصل الأول اللغة والسرد والأدبية والشعرية، وقُسّم إلى ثلاثة مباحث، تناول المبحث الأول اللغة في كتاب كتابة خلف الخطوط، في حين تناول المبحث الثاني السرد في الكتاب، أما المبحث الثالث فقد عُني بدراسة الأدبية والشعرية في النصوص وأثرها في البنية الجمالية. وجاء الفصل الثاني بعنوان دلالة العناوين والصور والمؤثرات البصرية، وقُسّم إلى مبحثين، تناول المبحث الأول دلالة العناوين في الكتاب، بينما تناول المبحث الثاني دلالة الصور والمؤثرات البصرية. أما الفصل الثالث فجاء بعنوان الزمان والمكان والشخصيات في النصوص، حيث تطرق المبحث الأول إلى الزمكان في كتابة خلف الخطوط وما له من دور في تشكيل العالم السردي، في حين استعرض المبحث الثاني الشخصيات في الكتاب وتحولاتها في ظل الحرب. وتضمنت الخاتمة أهم النتائج التي خلصت إليها الدراسة.