PIP: A great deal of attention is being devoted to the use of nonphysicians to provide such fertility control services as contraception, sterilization, and abortion. Legal obstacles exist, however, which must be overcome before the role of nonphysicians can be expanded. Such obstacles include medical practice statutes, nursing and midwifery legislation, and laws and regulations directly related to such fertility control measures as the provision of contraceptions and the performance of sterilizations. On the other hand, the following 3 main approaches have been used to permit increased participation of nonphysicians: delegation of tasks by physicians, liberal interpretation of existing laws, and authorization. Thus, the important elements in expanding the roles of nonphysicians are 1) authorization; 2) training; 3) qualification; 4) supervision; and 5) opportunities for referrals to physicians. The ultimate role of paramedicals will depend upon the continued simplification of technology, the results of research on the quality of care which they can provide, the attitudes of the medical profession, and the elimination of the legal ambiguities and obstacles which exist.
Concerned by the alarming decline in breast feeding in the urban and rural areas of Malaysia, we conducted a critical review of infant feeding practices among nursing personnel from representative centres using questionnaires. It was found that although 75% of mothers breast-fed their babies at birth only 19% did so at 2 months and 5% at 6 months respectively. Chinese mothers initiated breast feeding less frequently compared with Indian or Malay mothers. The prevalence of breast feeding was higher among lower category nurses, lower income groups and those from health centres. Decision for breast feeding was based in most instances on conviction derived from reading, lectures or advice from relatives. The vast majority of mothers listed "work' as the main reason for termination of breast feeding followed by "insufficient breast milk' and satisfactory past experience with bottle feeding. The ramifications of these findings and measures to improve the prevalence and duration of breast feeding are discussed.
A study of 50 healthy nurses from the University Hospital showed that 72% had chronic headache. Among those who had chronic headache, 33% were due to migraine. Another 30% were probable migraine subjects and 33% suffered from tension headache. Twenty two nurses had headache more than once a month and 18 nurses described the headache as moderate to severe. The common precipitating factors mentioned were tension, exposure to the sun, lack of sleep and menstruation.
The study reported served 2 purposes: 1) to assess the amount of sexual information posessed by a sample of staff nurses working for the National Family Planning Board and the Public Health Dept., and 2) to gather local normative data on the Information Subtest of the Derogatis Sexual Functioning Inventory (DSFI). The subjects for the this study were 2 groups of staff nurses. 10 were employees of the National Family Planning Board currently working in 1 of its clinics and 25 were public health nurses who were at a 1 week training at the clinic. The research was a questionnaire type study. Each subject was given the DSFI. On the Information Subtest of the DSFI the subjects obtained a mean score of 12.7 with a standard deviation of 4.2. This score is much lower than the normative mean (American population) and the sexually dysfunctional women mean. The nurses had inadequate and inaccurate knowledge about anatomy, physiology and psychology of sexual relations. Error analysis revealed that as a group they had poor understanding about male sexuality, the effect of aging on sexuality fertility and menopause, and difficulty in accepting oral-genital sex and sexual fantasies. This study recommends that these nurses, in order to more effective in their work, should be trained in the area of human sexuality. This training must include not only the physiology of sex but also the human aspects of sexual union.
The infectiousness with regard to HBV Infection of staff and patients in various units of the General Hospital, Kuala Lumpur
was assessed. It was found that all units, with the exception of the obstetric unit, were equally high risk areas. At least 50% of the patients in all these units had one or more of the markers. Among the medical staff, the anaesthetists had the highest
incidence of HBV markers (100%) while medical officers who had worked for three years or more were more likely to have to
have the HBV markers. The degree of infectiousness of the nurses In HDU and ICU/OT was found to be similar.
A serosurvey of rubella antibody among nursing personnel was carried out. 452 blood samples were received from a total staff of 829. 65% was found to be immune by the radial haemolysis method. The highest immune rate was in the intensive care unit followed by maternity, paediatric and gynaecology wards. The lowest rate was in the ophthalmology ward. This study shows that there is lack of compliance among medical personnel and the high immune rate is compatible with the occupational risk of contact with rubella.
Nurses are an integral component of the health care delivery system. In discharging their duties, nurses encounter a variety of occupational health problems which may be categorized into biological hazards, chemical hazards, physical hazards, and psychosocial hazards. A review of some examples of each of these four types of hazards is presented in this article. Particular attention has been devoted to hepatitis B, acquired immunodeficiency syndrome, tuberculosis, cytotoxic drugs, anesthetic agents, needlestick injury, back pain, and stress.
OBJECTIVES:
The aims of the study were, first, to determine the prevalence of Helicobacter pylori (HP) among endoscopy personnel and a group of non-endoscopy volunteers and, second, to evaluate the usefulness of two noninvasive tests of diagnosis: serology and the urea breath test.
METHODS:
The two noninvasive methods of HP diagnosis, serology and 14C-urea breath test (UBT), were used in a cross-sectional survey of endoscopists, nurse-assistants, and non-endoscopy personnel.
RESULTS:
One hundred and thirty-five volunteers were recruited for the study. In 116, results of the two tests were in agreement (kappa = 0.645). Further analysis was based on the results of the UBT. Endoscopy personnel (endoscopists and nurse-assistants) as a group had a significantly higher incidence of HP than did controls (32.9% vs. 11.3%; p = 0.004). The two groups were comparable with regard to mean age, sex, ethnic distribution, and social class.
CONCLUSIONS:
HP infection is more prevalent among endoscopy personnel. Both diagnostic tests (serology and UBT) were convenient and relatively simple to perform, and results gave a high level of agreement.
OBJECTIVE: To study the knowledge, attitudes and practices on various contraceptive methods among all government health clinic staff in the state of Kelantan.
DESIGN: Questionnaire-based study.
SETTING: All government health clinics in the state of Kelantan which are health facilities located outside the general hospital and seven district hospitals.
SUBJECTS: All 711 nursing staff employed in government health clinics in Kelantan state (sisters, staff nurses, assistant nurses and midwives).
METHOD: Pretested, prestructured proforma was sent out to all the nursing staff employed in all peripheral health centres to be completed by them and returned the same day via the medical officer in charge of that district.
RESULTS: Most of the respondents were more than 30 years of age, married, multiparous and working for more than 5 years. Eighty to ninety percent practised contraception, with the majority of midwives preferring pills and the majority of staff nurses preferring condoms. Thirty to forty percent from all groups felt that folk methods are effective, and should be encouraged. Only about 50% of staff nurses are well informed on all contraceptive methods, but among assistant nurses and midwives, this figure is only 33%. A high proportion felt that the nursing curriculum deals inadequately with this subject.
CONCLUSION: The first step towards achieving success in our family planning programme lies in imparting more information to this target group of health workers, by incorporating more lectures during training and sending them for courses.
PIP: 711 government health clinic nursing staff in Kelantan state were surveyed about their knowledge, attitudes, and use of various contraceptive methods. 11 sisters, 122 staff nurses, 173 assistant nurses, and 334 midwives returned the questionnaire the same day of receipt. Most respondents were older than age 30 years, married, multiparous, and working for more than 5 years. 80-90% practiced contraception, with the majority of midwives preferring oral pills and the majority of staff nurses preferring condoms. 30-40% from each subgroup of respondents believed folk methods of contraception are effective and worthy of being encouraged. Approximately 50%, 33%, and 33% of staff nurses, assistant nurses, and midwives, respectively, were well informed on all contraceptive methods. A high proportion of staff felt that the nursing curriculum fails to adequately address the subject. The authors stress that in order to realize success in the family planning program, more information must first be imparted to these health personnel. To that end, more lectures could be provided during training, followed by frequent and thorough refresher courses for all nursing staff.
A comparative study was carried out to assess Year I and Year III student nurses' attitudes and knowledge of the elderly. Significantly more Year I students disagreed that the elderly had a capacity to learn (chi 2 = 11.08, p = 0.0006). Year III students were significantly more likely to obtain information about the elderly from the mass media, agencies, and relatives but not from health personnel. Nearly all respondents (96.25%) in the study wanted to know more about the elderly. Only 3 of the 14 questions on ageing revealed significant differences in knowledge between the two groups. The basic course in gerontology should be expanded and revised to dispel erroneous attitudes, allow better understanding of the ageing process, and ensure entry-level competence in caring for older people.
This study was conducted to identify factors which influence the safety of children in day-care centres and home-based nurseries in the state of Kelantan. A total of 20 registered day care centres (DCC) and 40 home-based nurseries (IIBN) identified in 3 districts in the state were included in the study. Problems identified which could affect the safety of children cared-for in these nurseries were inadequate and unsafe facilities, inappropriate location of nurseries, lack of trained workers and their ignorance of necessary safety measures.
To determine how nurses handled drug-related questions in the work environment of a teaching hospital in Malaysia and the type of information sources they used.
This research describes a comparative study using convenience sampling on management of intravenous lines in Maternity Neonatal Intensive Care Unit (MNICU), HKL. Questionnaires were answered by nurses and the techniques of anchoring, splinting and maintaining of intravenous lines by nurses in MNICU were observed by the researchers. The study showed that nurses with less than two years experience working in MNICU had significantly less knowledge and skills in the management of intravenous lines and are likely to encounter more difficulties and complications, compared to nurses with more experience.
Risks of transfusion increase with the increase in the number and volume of transfusions occurring in hospitals year after year. Knowledge and practice of the nurses on proper transfusion techniques and risk reduction procedures should always be updated to ensure that transfusions are safely carried out. The study was done to determine the levels of knowledge and practice of trained nurses regarding blood transfusion in a general hospital. The study is a cross-sectional survey using a questionnaire, distributed to all staff nurses in the medical-based wards and intensive care unit (ICU) in the hospital. The total score were added for each category of knowledge and practice. Ninety one percent of the total population of staff nurses in medical based wards anti ICU were recruited into the study. A score of 80% or more in the knowledge and score of IOO% is required for practice to consider it as a pass, The outcome of the study showed that no one respondent in the study has achieved the required level, with regard to neither knowledge nor practice. The mean knowledge score was 54.8 with SD. of 9,9; while the mean practice score was 63 .8 with S.D. of 1.4. It was found that there was no rehtionship between knowledge score, nor practice score with the clinical postings (place of work) , work experience, and nursing qualification. This survey had indicated probkms faced by the nursing population in the hospital studied that there was a need to improve knowledge and practice levels with regards to blood transfusion procedure. It is crucial that updated information concerning transfusions be communicated to these nurses since they were the ones who carry out the procedures whilst continuously observing the patients during transfusion.
Occupational risk of Human Immunodeficiency Virus (HIV) infection is a matter of concern for health care workers. We conducted a study to gauge the level of awareness amongst HCW (doctors and nurses) working in Hospital Sungai Petani regarding the post-exposure prophylaxis in case of needle stick injuries from confirmed or suspected cases of HIV. Nineteen Doctors (56%) and 13 nurses (25%) were aware of correct risk of transmission. None identified all the four risk fluids correctly. 94% of doctors and 98% of nurses correctly stated that washing the site with soap and water is the initial procedure, but only few (1/10 of doctors and 1/3 of nurses) knew whom to contact immediately after injury. Twenty three doctors (67%) and 41(78%) nurses were aware of the use of Zidovudine but only 10 participants were aware of the use of second drug. Only 6 doctors (17%) and 8 nurses (15%) knew the correct duration of post-exposure prophylaxis. Twenty-three doctors (67%) and 35 nurses (67%) knew that the drugs were available in Hospital Pharmacy and 11 doctors and 12 nurses knew the approximate cost of therapy. On the average about 50% of doctors and nurses have fair knowledge of post exposure prophylaxis against HIV. Ongoing awareness and training are necessary to improve the same.