Background: Hospital medicine is characterized as a multifaceted team-based activity with a necessity for a high level of accuracy, timely, and reliable communication. Effective communication among healthcare providers is the key to successful collaboration within the healthcare system. Effective communication can improve patient safety, job satisfaction, and reduce burn out syndrome among nurses. The purpose of the study was to identify the factors contributing to the competency gap between and doctors in four private hospitals in Malaysia. Method: The study used a descriptive qualitative design to elicit the experience of 15 doctors from three private hospitals. A semi-structured interview was conducted to collect the data. The data were analyzed using Colaizzi's method for thematic data analysis. Results: The findings of the study suggested three main categories as the factors contributing to the communication gap among nurses and doctors as perceived by specialist doctors. The three categories include nurses training attributes, graduate nurse attributes, and work environment attributes. The nurses training attributes include entry requirements for student's recruitment into the nursing program, undergraduate training process, and assessment of student nurses. The graduate nurse's attributes had nine elements. The elements include a post-registration thirst for knowledge, medical English knowledge, self-confidence, stress management skills, critical thinking, and clinical judgment skills, perceived power on the authority of doctors, passion to work, time management skills as well as stress and personal factors of nurses. The working environment attributes included workload of nurses, teamwork among nurses Preceptorship, and appreciation of nurses by the organization. The informants also suggested measures to overcome the competency gaps among nurses. Conclusion: In conclusion, the nurse's communication competency is a vital factor in determining patient safety and quality of care. The quality of nursing care has a significant impact on the image of any health care organization. Therefore, it is crucial to identify the factors contributing to poor communication among nurses and doctors and to initiate interventions to fill the communication gap.
Introduction: Patient advocacy is a central concept for the profession of nursing as it assures patient rights and safety. This article presents the findings from a study which explored the perceptions of patient advocacy from Muslim ICU nurses. Methods and participants: Our study utilized a constructivist grounded theory approach. Thirteen registered intensive care nurses from an adult critical care setting in a tertiary academic teaching hospital in Riyadh, Saudi Arabia, participated in the study. The researcher employed semi-structured interviews that were digitally recorded and transcribed verbatim, with an additional data collection strategy of reflective journaling. A reflective journal was provided to all study participants following each interview. Results: The study generated codes which connected to vulnerable patients, and subsequently identified a core category of “Caring critically” which was exemplified by six additional inter-related advocacy categories of “Essential caring”; “Vulnerable-acy”; “Familial-acy”; “Cultural-acy”; “Religion-acy”; and “Human-acy”. These categories generated the model for patient advocacy. Conclusion: The pyramid of patient advocacy can be applied in clinical practice to guide Muslim nurses, in addition to being utilized in the educational setting as a standard to teach registered nurses about the role and responsibilities of a patient advocate.
The main objective of this study is to evaluate the nurses' level of burnout and identify the factors that influence it. Burnout, one such stress-related outcome, has been conceptualised as a multidimensional construct consisting of emotional exhaustion, depersonalisation and reduced personal accomplishment. Items adapted and translated from Maslach Burnout Inventory were used to collect data from 60 respondents. Among the respondents, 5.0% showed a high level of Emotional Exhaustion while 95.0% were at the moderate and mild level. Respondents with a high level of Depersonalization constitute 3.3% while 96.7% were at a moderate and mild level. Analysis show that 48.2% are at the high and moderate level for Personal Accomplishment while 51.7% is still at the lower level. Mean score for Personal Accomplishment 33.53 as oppose to Emotional Exhaustion 15.90 and Depersonalization 3.60 indicate a low level of burnout characteristic among the staff nurses. Correlation analysis suggest a significant but moderate relationship between Emotional Exhaustion and Depersonalization r = 0.62, p<0.05. A conducive working environment was suggested as a way of improving quality of health care and to hinder burnout. Keywords: Retirement, Readiness, Financial Capacity, Social Support, Preoccupation
This quantitative-oriented research was conducted to identify factors that contributed to errors in dispensing medication among nurses and to understand why nurses did not report their errors in dispensing. In this study a total of 284 U29 nurses participated in focusing on factors contributing to medication errors and failure to report the errors. In this study, analysis of the data collected was made in two sections; dispensing errors and failure to report the errors in giving medication. According to Evans et al. (2006) although nurses may not admit directly to such errors, they expressed their perceptions towards situations described in the questionnaire items as contributing to medication errors among nurses. Almost all in the sample of 284 chose not to report medication errors because they could not identify the cause of dispensing errors; other nurses perceived that the individual involved is not competent in performing the task. Other reasons include fear that the action will be exposed by the management, to avoid publicity from the media, and there is no difference in reporting or not reporting the medication errors. This study was done not only for exploring factors of medication errors; it also aspires to identify problems that arise in hospital services and in order to maintain the quality of health care. The management should consider the impact of medication errors and failure to report medication errors on the nursing profession and quality image of the hospital.
Caring behaviours presented by the nurses while providing care is the essence of nursing. However, operation theatre nurses must also adhere to the nursing value in social sciences and humanities to address the patient's needs. The concern of the nurses should not only be for the basic life sustaining needs but also for physiological, psychological, socio cultural and spiritual dimension ofpatient's human responses. The purposes of this study were to determine the perception regarding caring behaviours and the level of caring among the Operation theatre nurses in Hospital Universiti Sains Malaysia. In addition, there were associations when the determination between demographic variables like genders and years of experience of the nurses in relation to their caring behaviours is necessary. It isa quantitative, descriptive survey design and 95 nurses participated in the study. The revised Wolfs Caring Behaviours Inventory was used to measure the dimensions of caring. "Professional knowledge and skill" was identified to be the highest among the five dimensions of caring that was being measured. Findings show that the nurses demonstrated a high level of caring behaviours during their course of work. However, none of the demographic factors studied were significantly associated to their caring behaviours.
Keywords: Caring attitudes, Caring behaviours, Dimensions of caring
Clinical practice is an essential component of the nursing student's training. The practice allows nursing students the opportunity to relate theory into practice during nursing care to the patients. The aim of this project was to determine perceptions of clinical placement experience with respect to clinical practice, enhancement of learning and hindrance among nursing students. A total 254 participants undergoing training at Nursing College Kubang Kerian participated in this project. They were selected using the Raosoft sample size calculator. Survey questionnaires were distributed to 80 participants from ﬁrst year, 88 from second year and 86 participants from third year. The questionnaire consisting of 25 items with 5-point Likert Scale responses was used to measure nursing students' perceptions towards nurses during their clinical placement experience. In addition, demographic factors such as age groups, ethnicity, educational levels and years of training were examined. The items were pilot-tested and the Cronbach Alpha values obtained for clinical practice, enhancement of learning and hindrance consisting of 0.80, 0.80 and 0.83 respectively. The ﬁnal data was analysed using both descriptive and inferential statistics. Non-parametric Kruskal Wallis was used to make comparisons where sub samples were imbalanced. The level of signiﬁcance was set at 0.05. The results indicate that nursing students perceived their clinical placement positively. Perceptions towards clinical practice were signiﬁcantly different between nurses based on their residential areas and years of training. The results of this study revealed that there were challenges for the nursing educators, clinical instructors and other health providers in achieving a supportive clinical environment for the nursing students.
Keywords: Nursing, Clinical Placement, , Clinical Practice, Enhancement or Hindrance in learning
Neonate Resuscitation Program, NRP training is given to nurses in batches. Such programs are vital because neonate resuscitation procedure or aid given to new born during delivery, help them begin breathing on their own, which can save many lives. Although such training is given to the nurses, no assessment has been done on the effectiveness of such training with regard to knowledge retention and transfer of training among the trainees. This study is retrospective in nature; it evaluates the level of knowledge and the conﬁdence in carrying out the neonate resuscitation procedure among 91 nurses involved such training. Besides that, the study ascertains their preparedness before undergoing the training and the opportunities provided to them to practice the skills learnt from the training at their work place. Factors that inﬂuence both their knowledge and skills after the training are also indentiﬁed. Study sample consist of 51 nurses from hospitals and 40 nurses from health clinics. Results show that skills acquired from training as measured by their conﬁdence at carrying out the learnt skill deteriorate faster than knowledge. Level of knowledge retained, conﬁdence at carrying out the neonate resuscitation procedure and opportunities for practicing the skill are all signiﬁcantly higher for the nurses at the hospitals compared to their counterparts in the health clinics at the 95 percent level. The recent trainees (2009) scored higher compared to the old trainees (2007 and 2008) with regard to their preparedness or motivation before the training although memory factor could play a part here. Conﬁdence at carrying out the neonate resuscitation procedure at the work place is a measure of the effectiveness of the NRP training because it constitutes transfer of training. Level of knowledge retained and opportunities for practicing skill at work place after the training, together with trainees' preparedness and motivation before the NRP training, all three contribute 35.7% towards trainees' conﬁdence in carrying out the NRP procedure at their work place. Contribution of these three variables is signiﬁcant at the 95% level or p< 0.05. Findings are consistent with the Model of factors that affect Learning Outcomes and Transfer of Training by Goldstein and Ford (2002).
Keywords: NEONATE RESUSCITATION
Nurses play a key role in caring for the mentally ill and in rehabilitating them after an episode of illness. The nurses' attitude towards a patient is generally considered to be one of the basic factors contributing to the administration of total therapeutic nursing care. The purpose of this study was to examine whether attitudes towards mental patients improve after psychiatric attachment as well as the relationship between attitudes to psychiatry and intention to pursue psychiatry as a career. The study was conducted on sixty nursing students of fifth semester at the Kolej Kejururawatan Kubang Kerian, Kelantan who are doing their psychiatric postings in Hospital Raja Perempuan Zainab II, Kota Bharu. The sampling technique for this study was convenient sampling. The instrument used for this study surveyed questionnaire developed by Brenda Happell (Happell, 2008). This quasi-experimental study measured changes in students' attitudes and satisfaction with clinical experience following a placement in mental health nursing. The questionnaire was administered to the nursing students on the first and last day of their psychiatric clinical placement session. The findings suggested that clinical experience during psychiatric clinical posting can positively influence attitudes, preparedness for practice and the popularity of mental health nursing. Satisfaction with clinical experience was also high. The findings of this study suggest that clinical postings had positive effects on nursing students' attitudes towards psychiatric patients and confidence in this field of practice.
Study site: Hospital Raja Perempuan Zainab II, Kota Bharu
The aim of this project was to determine stress levels and to identify the main stressors that contribute to stress among Kolej Poly-Tech Mara (KPTM) nursing students during their clinical placement in order to help them overcome it. Atotal of 324 respondents undergoing training at KPTM participated in this project. The questionnaire consisting of six common stressors with 30 items using a 5-point Likert Scale was used to measure the level of stress among the respondents during their clinical placement. The data collected was examined for normal distribution, and inferential statistics such as correlations were used to seek relationships. The results indicated that the main stressors that contributed to stress among KPTM nursing students were from both environment, along with assignments and workload. There was moderate level of stress among KPTM nursing students during clinical placement and the factor that contributed to stress was due to the the possibility of making an error. Clinical placement is an essential component for nursing student's training. The practice allows nursing students the opportunity to relate the theory into practice during nursing care towards the patients. Findingsfrom this study will provide the nursing educators, clinical instructors with a meaningful understanding of the importance of clinical placement experience.
Low back pain is a common occupational health issue especially among nurses that leads to suffering, disability and days of work lost that affect the continuity and quality of patients care. This study aims to determine prevalence of low back pain among registered nurse at Surgical Unit in RPZ II Hospital and identify the associated factors. It is a cross-sectional study that used a self-administered questionnaire to collect the data among a convenience sample of 60 nurses. Data was analyzed using Pearson Chi-Square. Majority of them were aged 31 to 40 years (53.3%), Malays (91.5%), married (84.6%), had working experience from 11 to 15 years (50.8%), had formal manual handling training (64.9%) and are overweight(58.3%). The prevalence of low back pain was 63.8%. The study revealed statistical significance for race (p=0.002), number of patients they have to handle (p=0.005), satisfaction with working environment (p=0.007) and emotional and social problems (p=0.007, p=0.038, respectively).
The profession of Nursing has taken a huge leap forward both during the time of Florence Nightingale to
today's modern age. This article sheds light on the journey of nursing, from its humble roots to Nightingale's
contributions and the various breakthroughs of the present along with a focus on the pros and cons as well as
the strengths and weaknesses of Nursing in both Nightingale's and today's time. Various aspects in both time
periods are considered in this article along with a note that emphasizes on the contemplation rather than
outperformance in the field of Nursing in both time periods.
Stroke is the most important cause of death and foremost cause for dysfunction around the globe. As a result increase in the numberof elderly population the incidence of stroke has emerged as an important public health problem. Major developments have taken place in the field of medication for the prevention and treatment of stroke during the past decade. In spite of major interventions proposed by several organizations and the government, the present scenario of the stroke management facilities is still not promising. This article intends to investigate the health care facilities present for the elderly individuals with high risk of strokereoccurrence through proper analysis of the health system in Malaysia. The objectives are to find out evidence-based, reasonably priced and endurable measures to control the recurrences of stroke and to evaluate the outcomes of these interventions. It was noticed that in Malaysia though there many amenities for stroke patients are available but reorganizing and strengthening of few aspects such as human resource by multidisciplinary input is necessary for proper management of senior stroke patients. Moreover monitoring is essential to support patients after discharge from the hospital. The ethical variations among patient with stroke recurrence and the risk factor associated with stroke is not fully understood by healthcare workers. So, this study attempts to guide the stroke patient, their families and the health care workers to prevent stroke recurrence.
Keywords: Stroke, Stroke Interventions, Stroke in Malaysia
Exercise is an important practice in leading a healthy lifestyle. However, recently the percentage of
Malaysians who practice healthy lifestyle has decreased and the rate of overweight or obesity isincreasing.
This study aims to explore the knowledge, attitudes and practices of exercise among nursing college
students. Questionnaires were used as a research instrument and distributed to Kuala Terengganu Nursing
Collage students consisting of 281 students, ranging from year 1 to year 3 in semester II. Data collection
was carried out within two weeks. The results of this study showed that almost 66.9% of trainees chose
aerobic exercise as their favorite exercise. This form of exercise is good for strength and durability of the
cardiovascular. Almost 90.4% of them did exercises together with their friends. From the results, their
coach had a relatively good level of knowledge about exercise. The majority of students have a positive
attitude towards exercise. There is a relationship between knowledge and their value of exercise. Age is
correlated with knowledge, meaning that the older the person the more knowledgeable they are on the
benefits of exercise. Age and semester of study showed moderate correlation of 0.525 with awareness of
exercises to increase stamina and strength of the body's defenses.
Diabetes is a chronic complicated disease. For that reason, self-care management and education are necessary to control blood glucose levels to decrease mortality and morbidity rate, the risk of complications and adverse medication related events. Lack of knowledge about a diabetic medication and non-adherence contribute to poor glycemic control among diabetes patients. Therefore, this study aims to assess relationship between medication knowledge and medication adherence among T2DM. A cross sectional study was carried out in outpatient's diabetic clinic in University Malaya Medical Centre via recruiting 250 participants. A set of questionnaires from earlier research were used to collect the data. Descriptive and inferential statistical analysis is used to analyze the data. The inclusive results indicated that, the mean age of the participants was 57.90 ±13.22 within 56years. More than half of patients (52.5%) had poor medication knowledge, and 47.5% had good knowledge. In terms of medication adherence, most of the participants (87.0%) had medium medication adherence; whereas, only 1.3% showed high medication adherence. However, there was no correlation between medication knowledge and medication adherence (p=0.743). The chi-square results indicated that medication knowledge was associated significantly with gender, educational level, employment status and monthly income (p value < 0.05). In conclusion it can be said that this study provides insight for healthcare professional about medication knowledge and adherence which are important for managing diabetes. Awareness of these factors will allow them to be more effective about medication counseling so that patients can become self-responsible and realize the benefits of prescribed therapies.
Study site: Diabetic Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
This paper aims to review the literature with regards to the family caregivers of severe traumatic brain injury survivors and their needs for care at home. The search started by finding the relevant keywords from EBSCOhost: MeSH database. There were many related studies found by searching the following multiple databases. They are from Evidence Based Medicine (EBM) reviews @ Ovid, Journal @ Ovid Full text, Medline with Full text via EBSCOhost, CINAHL Plus with Full Text, Science Direct, and Google scholars' articles. The search terms were limited to publications ranging from 2010 to 2016. Several points were highlighted regarding the needs of family caregivers who had been taking care of traumatic brain injury survivors. It also provided information on the needs of family caregivers in terms of care, traumatic brain injury, TBI survivor complications, family caregiver's burden, caregiver challenges and the impact of traumatic brain injury to family caregiver's quality of life. Overall, the study shows that family caregivers face significant challenges toward care of TBI survivors. The review highlighted the support needed from the family caregivers, and other important facts about severe traumatic brain injury in order to understand the condition. Further research should focus on rehabilitation efforts on traumatic brain injury survivors.
Thyroid disorders could be broadly categorised into benign and malignant diseases. Approaches for the
management of benign and malignant thyroid disorders have been well documented including the treatment
using radioactive iodine (RAI). RAI has long been used to treat hyperthyroidism and well differentiated
thyroid cancer. Nevertheless, there are various factors that may influence the outcome of RAI treatment
including matters related to patient preparations. Thus, healthcare personnel play an important role in
assisting patients to make the necessary preparations. This article aims to give nurses and clinicians of
various specialities an insight into the overview of RAI treatment for thyroid disorders particularly in
Malaysia and further discusses the issues related to preparations of patients.
Medication errors could bring serious consequences to patients. Reporting medication error is a strategy to
mitigate such incidence from happening. Unfortunately, some nurses do no report the errors due to certain
factors. Determining the factors influencing unreported medication errors will ensure imperative actions
that are to be taken to curb this issue. The aim of this study is to determine the prevalence and perceived
causes of unreported medication errors among nurses in a public hospital in Selangor. A descriptive and
cross-sectional study was carried out in 26 wards from various disciplines and the sample involved 234
nurses. The data were gathered through self-reported questionnaires consisting of three sections. The first
section covered demographic characteristics, the second section aimed to obtain information on the
frequency of medication error incidents and the last section aimed to obtain information on nurses'
perceptions of barriers in reporting medication errors. The findings of this study indicated that there was a
significant relationship between level of education and the nurses' perceptions of barriers in reporting
medication errors. The study recommended that providing enough education, initiating a non-punitive
culture may help increase voluntary reporting of medication errors among nurses to strengthen the
reporting system and to avert medication errors in the future.
Introduction: Critical thinking is an important element in nursing practice as well as being a vital educational outcome in any nursing curriculum. Critical thinking can influence the outcome of patient care and patient satisfaction. Objective: To determine the level of critical thinking ability among nursing students in two nursing colleges and its differences according to social demographic variables. Method: This was a cross sectional descriptive study design in which Critical Ability Scale for College Students were used to collect data from 158 nursing students in two private nursing colleges in Malaysia. Participants were recruited through convenience sampling. Results: The mean overall score for critical thinking ability was 70.6±6.98 with scores ranging from 56 to 89. The mean score of the subscales was 3.63±0.50 for intellectual, eagerness and health skepticism abilities, 3.63±0.42 for intellectual honesty ability, 3.61± 0.41 for prudence ability and 2.68±0.64 for objectivity ability. There are no significant differences between the independent variables and level of critical thinking ability. Conclusion: A high critical thinking ability score was reported with intellectual, eagerness and health skepticism being the highest subscale. The way forward requires academicians and clinicians to work together to ensure a transfer of knowledge and skills from the classroom to the clinical environment in order to develop and enhance the ability to think critically in making clinical decision and produce thinking nurses for the future.
Diabetes Mellitus has become one of the major and rising diseases affecting population all around the world. The most common complication that rises from the Diabetes Mellitus is diabetic foot ulcer. The increasing rate in diabetic foot ulcer among elderly has become a challenge that continues to rise and worsen. This study is conducted to determine the knowledge and practice of foot care and also the relationship between socio demographic data with knowledge of foot care among diabetic elderly in UKM Medical Centre (UKMMC). This is a quantitative cross-sectional descriptive study. A total of 81 respondents are being participated in this study. More than half of the study participants are female and majority of them are 60-74 years old. The result showed a significant relationship between gender and marital status with the knowledge of foot care among elderly diabetic patient in UKMMC. The present study showed that there was no significantly relationship between age, occupation, monthly income, duration of diabetes, body image and level of education with the knowledge and the level of foot care. In conclusion, the result of this study will help the health organization, hospital, nurses and care giver to take more responsibilities of foot care for diabetic elderly individuals.
Study site: Elderly patients from orthopaedicf emale or male ward, surgical ward, medical ward, orthopaedic clinic and medical clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Family members' satisfaction has become an important measurement in determining the quality of care of patients in the critical care setting. The aims of the study were to determine the satisfaction level of family members, to determine the reliability of family satisfaction and its subscales, to identify mean of each question and their subscales. A cross-sectional study was conducted on 30 family members who accompanied patients during intensive care admission. The study was conducted in a critical care setting in
a high dependency unit (HDU) and cardiac intensive care unit (CCU), Hospital University Sains Malaysia (Hospital USM). The data was collected from October 2012 to January 2013. The Critical Care Family Satisfaction Survey (CCFSS) Malay version was used to measure family satisfaction in addition to the collection of demographic data. The statistical analysis used a descriptive approach. Ethical approval was obtained prior to data collection. Majority of the respondents were female: 23 (76.7%). Mean age was 35.67 years (SD=12.83) and the score of overall satisfaction level was 78.80 (SD=13.88). The Cronbach's alpha was 0.96. A majority of the respondents, 19 (63.3%) were satisfied with the care provided. This study showed that a majority of family members were slightly satisfied with the care that was provided in a critical
care setting at HUSM. It also showed that families play an important role in giving support and hope to patients.
Study site: HDU and CCU, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia