Form.

Form 2: Research Proposal

The Role of Nursing Management in Enhancing Quality of Care in Outpatient Departments in Saudi
Arabia: A Systematic Review

by

Afnan Mohammed Alharbi
G230002550
Master of Healthcare Administration
Under supervision of
Dr. Navya Rajashekharan Nair

202420
College of Health Sciences

Saudi Electronic University

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Background
Worldwide, healthcare organizations are adapting their operations to serve expanding diverse
patient populations (Durrani, 2016). Vision 2030 guides Saudi Arabia’s healthcare transformation as
the nation dedicates its focus to building superior infrastructure while developing better services
and optimizing patient care (Alasiri & Mohammed, 2022). Outpatient departments serve as
foundational healthcare components that maintain patient pathway control and deliver
preventative and specialized medical services. Patients contact these departments first to receive
treatment and care for their diverse medical requirements including chronic disease management
and specialized consultations and preventive services (Samadbeik et al., 2024). Despite
substantial progress, OPDs in Saudi Arabia face considerable challenges, such as overcrowding,
long wait times, and inconsistencies in care quality. The issues decrease both outpatient service
effectiveness and patient happiness and health results (Alrasheedi et al., 2019). Healthcare
facilities need to adopt continuous management improvements because service demand
continues to rise.

Problem statement

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The success of healthcare services depends heavily on nursing management because OPDs
require effective leadership together with operational efficiency. A significant gap exists within
existing research regarding the precise role of nursing management in improving care quality for
Saudi Arabian OPDs (Al Mutair, 2015). Nursing leadership remains vital for developing efficient
resource allocation and collaborative partnerships and delivering personalized healthcare. The
practice of nursing management comes with many hurdles, according to Ball & Griffiths (2022),
which combine workplace stress between administrative work and direct patient care and
managing staff members from various backgrounds with ongoing system problems centering on
staff stability and deficient training as well as inconsistent service quality (Ball & Griffiths, 2022).
Additionally, the implementation of standardized protocols and ongoing professional development
remains crucial for improving nursing management complexity at OPDs. The delivery of nursing
care in this setting is influenced by cultural elements that combine expatriate nurse integration with
Islamic healthcare practices (Alsadaan et al., 2021). Distinct operational obstacles demand
specific approaches to advance both clinical service delivery and treatment standards.

Research gap
The existing literature on nursing management in Saudi Arabia’s outpatient departments (OPDs)
largely overlooks the specific role of nursing leadership in improving care quality. While some
studies explore the challenges of overcrowding, long wait times, and inconsistent care delivery in
OPDs, there is limited focus on how nursing management practices can directly address these
issues. Moreover, gaps exist in understanding the impact of nursing leadership on operational
efficiency, resource allocation, and patient satisfaction in this context. This research aims to bridge
these gaps by investigating the strategies and outcomes associated with nursing management in
enhancing OPD care quality across Saudi Arabia.

Research question/s
1. How does nursing management impact patient care quality and satisfaction in outpatient
departments (OPDs) in Saudi Arabia?
2. What are the key challenges faced by nursing managers in balancing administrative duties
and clinical responsibilities in Saudi Arabian OPDs?

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3. What strategies can nursing management implement to improve operational efficiency and
reduce wait times in OPDs while maintaining high-quality patient care?

Aim of the study
This study aims to examine the role of nursing management in enhancing the quality of care in
outpatient departments (OPDs) in Saudi Arabia by identifying key challenges, evaluating its impact
on patient satisfaction, and exploring effective strategies for improving operational efficiency.

Objectives of the study
The objectives of this study are to:
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Analyze the impact of nursing management on patient care quality and satisfaction in
outpatient departments (OPDs) in Saudi Arabia.
Identify key challenges faced by nursing managers in balancing administrative duties and
clinical responsibilities in OPDs.
Evaluate the effectiveness of current nursing leadership strategies in improving operational
efficiency and reducing wait times.
Explore best practices and evidence-based strategies for enhancing nursing management
to optimize patient outcomes in OPDs.
Assess the influence of cultural and systemic factors on nursing management practices in
Saudi Arabian OPDs.

Significance of study
This study is significant as it addresses a critical gap in understanding the role of nursing
management in enhancing the quality of care in outpatient departments (OPDs) in Saudi Arabia.
With increasing patient demand and the ongoing transformation of the healthcare system under
Vision 2030, effective nursing leadership is essential for improving patient satisfaction, reducing
wait times, and ensuring efficient resource allocation. By identifying key challenges and evaluating
evidence-based strategies, this research will provide valuable insights for policymakers, healthcare
administrators, and nursing professionals to implement management practices that enhance
operational efficiency and care quality. Additionally, the study will contribute to the broader field of
healthcare management by examining how cultural and systemic factors influence nursing
leadership in Saudi OPDs, ultimately leading to improved healthcare outcomes and patient
experiences.

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Review of Literature

Introduction
Healthcare institutions throughout the world have started implementing fast changes to adapt to
rising patient diversity needs. Hospital authorities in Saudi Arabia, under Vision 2030, accelerated
infrastructure development and service delivery improvements throughout outpatient
departments. Healthcare delivery begins at OPDs because patients first connect with these
departments to manage chronic diseases while receiving preventive services and specialized
medical evaluation. The healthcare sector continues to grow quickly but patient satisfaction along
with healthcare results suffer from the combination of crowded facilities and extended waiting
periods with inconsistent care services. The leadership role of nursing management stands
essential for resolving OPD care issues in Saudi Arabia, yet research assessing its particular
contribution to quality improvement remains scarce. This review examines scholarly research
about how Saudi OPD care quality benefits from nursing management approaches, together with
the principal barriers and successful strategies and results.
Quality of Nursing Care in Saudi Arabia
Saudi Arabia’s healthcare system has progressed well, yet healthcare professionals identify
multiple critical areas that require improvement, specifically in outpatient departments (OPDs).
According to Al Mutair (2015) Saudi Arabia continues improving healthcare services yet faces
obstacles because of inadequate nursing staff training and inconsistent professional standards.
Healthcare delivery shows inconsistent results because nurses are scarce and this leads to worse
patient outcomes (Alasqah et al., 2022). Alkorashy and Al-Hothaly (2022) explain how nursing care
serves as a crucial component for achieving Vision 2030 healthcare transformation success. The
authors argue that nursing care stands as a fundamental aspect requiring transformation because
healthcare delivery protocols need to match international quality benchmarks (Alkorashy & AlHothaly, 2022). When properly managed, nursing operations function as a critical driver toward
enhancing medical care quality. Research done by Ali et al. (2024) shows that proper nursing
practice environments supported by sufficient staff, resources, and backing systems lead to
exceptional patient results (Ali et al., 2024). Nursing managers working in OPDs experience
difficulties between managing administrative work and clinical tasks due to which they struggle to
execute quality improvement programs (Alsadaan et al., 2021).
Impact of Vision 2030 on Healthcare Transformation
Saudi Arabia’s Vision 2030 launch drove major changes to healthcare through enhancements for
quality delivery and efficiency while increasing patient contentment. The review by Alasiri &
Mohammed (2022) traces Saudi Arabia’s healthcare evolution after Vision 2030 started showing
investments in healthcare infrastructure alongside technology deployments and workforce
preparation. The healthcare system faces ongoing difficulties in outpatient departments because
patient number growth exceeds treatment capacity, leading to space shortages and delayed

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medical services (Alasiri & Mohammed, 2022). Patient navigation through healthcare challenges
becomes possible through nursing management, which optimizes resource distribution and
establishes strategies to improve patient movement. Results from Almutairi et al. (2024) illustrate
how Saudi OPD patients determine their satisfaction levels based on waiting durations and service
quality received. The intricacy of patient journey management creates high stress and burnout for
nurses who handle these responsibilities at the nursing manager level. Additionally, Alrasheedi et
al. (2019) demonstrate a robust connection between waiting periods and patient satisfaction
ratings and argue that improved patient results can come from shorter wait times through skilled
nursing administration.
Challenges Faced by Nursing Management in OPDs
The quality of care in OPDs suffers from multiple challenges that nursing managers must
overcome. Overcrowding persists as a continuous challenge for emergency departments across
Saudi Arabia, as Almass et al. (2023) report alongside OPD wait times issues. Patients experience
lower satisfaction rates while waiting longer because staffing shortages combine with delayed
interventions and poor department connections. Hospital systems encounter distinct difficulties
when integrating expatriate nurses because cultural adaptability and professional norms
integration, along with language differences, create barriers to smooth patient care delivery (Alasiri
& Mohammed, 2022). Nursing management strongly depends on both the retention of nursing staff
and their job satisfaction levels. The research of Alsadaan et al. (2021) examines how nurse
retention in Saudi Arabia struggles with elevated staff turnover and the lack of professional
advancement possibilities. Healthcare services demand continues to rise while nursing managers
face strong pressure to provide quality care with restricted resources (Alsadaan et al., 2021).
Professional nursing handlers require effective management strategies that focus on workforce
development, enhancing workplace satisfaction, and maintaining a sustained nursing workforce.
Role of Nursing Management in Enhancing Patient Satisfaction
The effectiveness of nursing management stands as a primary decision factor that improves patient
satisfaction levels in Saudi OPDs. According to Almutairi et al. (2024), the delivery of rapid medical
care and the prompt fulfillment of patient requirements depends on effective nursing management.
Patient experience enhancements require three essential methods including adjusting staffing
numbers properly and strengthening nurse-patient relations along with cutting down waiting
periods. Nursing managers need to actively teach staff about patient satisfaction importance and
its effects on healthcare results according to Alrasheedi et al. (2019). Research findings by Alotaibi
(2024) demonstrate that enhancing patient-centered care delivery directly enhances patient
satisfaction metrics. Nursing managers have to guarantee that OPD care provides customized
treatment that shows respect for individual patient requirements (Alotaibi, 2024). The improvement
of technical care must be accompanied by the development of patient-centered interactions that
are both compassionate and empathetic.
Strategies for Improving Quality of Care in OPDs
Several approaches have been presented to enhance the quality of care delivery in Saudi OPDs.
The creation of standardized care protocols represents a crucial necessity for maintaining both
reliable and superior quality care, according to research by Alkorashy and Al-Hothaly (2022).

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Standardized care procedures create uniform treatment delivery, which results in equal patient
attention and care no matter which healthcare facility patients enter. According to Alasqah et al.
(2022), nursing staff must participate in continuous professional development because ongoing
training and education keep care standards at their highest level. Furthermore, Ali et al. (2024)
highlight that the development of productive nursing practice spaces with sufficient resources
alongside dedicated support and strong leadership results in better patient care outcomes (Ali et
al. 2024). Nursing managers need to make staff well-being, along with professional development
and collaborative efforts, their top priorities to provide high-quality care.
The literature review shows that nursing management stands as an essential factor which improves
the quality of care delivered in Saudi OPDs. Vision 2030 has yielded substantial progress in
healthcare, but Saudi OPDs still deal with patient congestion, delayed appointments, and care
inconsistency. Nursing managers encounter distinctive obstacles while they work to handle
administrative tasks alongside clinical work and handle staffing problems as well as cultural
diversity. Evidence points to well-managed nursing practices as a solution to improve patient
satisfaction while maximizing resource allocation and shortening waiting periods, which produces
better quality patient care outcomes.

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Methodology
Study design
A systematic review design will be used to examine secondary data sources, according to Phillips
and Barker (2021). The methodology seeks to organize existing studies and secondary data that
examine nursing management practices for outpatient department quality care enhancement in
Saudi Arabia health facilities. The review investigates existing research reports alongside published
works to find significant gaps in current literature while abstaining from new primary data gathering.

Ethical considerations

As this research relies solely on secondary data sources, the ethical components of this research
prioritize academic integrity and the appropriate management of available literature during every
stage of research. Intellectual property stands as a fundamental ethical concern that needs proper
attention. This systematic review properly cites academic standards for all sources utilized
(Zhaksylyk et al., 2023). Acknowledging original authors guarantees both intellectual property rights
protection and prevents plagiarism. Attaining appropriate resource citations in this process fulfills
ethical principles and shows scholarly regard to academics within the field. Another important
ethical consideration is confidentiality and privacy. Since the research relies on secondary data
without direct interviews with participants, the protection of personal information remains minimal.
The researcher completely complies with data privacy ethical principles for research projects
handling sensitive identifiable details, especially healthcare records (Tripathy, 2013). All data will be
managed responsibly through protocols that protect confidentiality standards.
Transparency and honesty are also essential for maintaining ethical conduct throughout this
research. The systematic review procedure follows an open approach that maintains the chosen
method for selecting research, data acquisition, and analysis according to established
criteria(Tripathy, 2013). The systematic approach reduces subjective influences while maintaining
objective results and the capability for repeatable findings. The research findings will present data
precisely and maintain their original nature since they represent evidence from chosen studies
without data alteration or misrepresentation. Finally, research integrity is vital to preserve the
study’s reliability and credibility. The research will display discovered data from secondary sources
truthfully to prevent evidence alteration (Zhaksylyk et al., 2023). Conclusion will only be made from
collected data while strictly avoiding selective reporting. Maintaining these ethical standards leads
to true research findings and gaining community trust.

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Study instrument
The study will apply a systematic review protocol as its research tool. Systematic review protocols
need to establish clear selection principles and review frameworks that guarantee precise and
uniform operating approaches (Jahan et al., 2016). The systematic review protocol analyzes
information from peer-reviewed articles together with government reports, institutional studies,
and healthcare databases. The research aims to explore how Saudi Arabian OPDs operate by
analyzing nursing management approaches together with leadership models and patient service
quality and staff levels.

Sampling strategy
The research depends solely on secondary data, so the selected studies will be sampled according
to their relevance to the research question. The research design gathers studies from different
databases that investigate OPD nursing management through a Saudi Arabian healthcare
framework (Palinkas et al., 2015). The research investigates Saudi Arabia’s healthcare system,
which incorporates urban and rural healthcare facilities nationwide within its healthcare facility
setup strategy.

Data collection
Data collection will involve gathering secondary data from peer-reviewed articles, government
reports, institutional studies, and healthcare databases. The selection of studies will be based on
their relevance to nursing management practices and quality care in Saudi Arabian outpatient
departments (OPDs). Databases such as PubMed, Scopus, and Google Scholar will be utilized to
identify studies. Relevant studies will be selected after reviewing abstracts and full texts. Data
extraction will include key characteristics, outcomes, and findings from the studies, ensuring a
comprehensive synthesis of existing literature to address the research questions related to nursing
management in OPDs.

Data analysis
The research will use thematic synthesis to analyze the findings. The analysis will use major
elements and repetitive sequences within nursing management practices alongside the quality of

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care delivery and leadership approaches, staffing needs, and patient results. The research results
from different studies become interconnected through thematic analysis, which produces an
extensive understanding of how nursing management affects quality care delivery in OPDs (Naeem
et al., 2023). The analysis will assess current practice strengths alongside identified challenges by
examining solutions introduced to the literature.

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Research Plan and timeline
Month/s
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February

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March

April

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May

Tasks
Conduct literature search: Choose relevant databases (like
PubMed, Scopus, and Google Scholar) and use keywords to find
studies on nursing management and quality care in OPDs in Saudi
Arabia.
Select and review studies: Review studies, read abstracts and full
texts, and decide which studies to include based on the research
question.
Data extraction: Extract relevant data from selected studies,
including study characteristics, outcomes, and findings.
Data analysis (thematic synthesis): Analyze data, identify
recurring themes and patterns, and organize findings into thematic
categories.
Drafting the report: Write the research findings, discussion, and
conclusions. Ensure proper citation and referencing of all sources.
Final review and submission: Make final revisions based on
feedback, ensure quality of work, and submit the completed research
report.

Reviewed and Approved by the Supervisor

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