Introduction: Peripheral Intravenous Cannula (PIVC) placement can cause undesirable effects, such as phlebitis. Poor PIVC care can irritate tunica intima layers of the superficial vein. The incidence of phlebitis had become a national nursing indicator, with a standard of less than 0.9%. The standard care of the patient with intravenous in- cludes a routine PIVC assessment. However, what the assessment should be based on remained unclear. The objec- tive of this study is to assess nurses’ skill in performing PIVC assessment. Methods: This is a descriptive study using an audit-based approach. It is conducted in a pediatric hospital. Nine pediatric wards were identified via stratified sampling methods. A total of 86 registered nurses consented to participate in this study. A validated research instru- ments (α = 0.83), PIVC Assessment Skill (PIVC-AS) checklist is used to audit nurses in performing PIVC assessment. PIVC-AS consists of nine audit criteria (AC), AC1: communication skill, AC2 until AC7: PIVC assessment skill, AC8: documentation skill and AC9: PIVC management. Results: Nurses communication skills to patient as in AC1 shows compliance rate of seventy six percent. The compliance rate can be explained that this study was done in the pedi- atric setting. Participants may skip this communication due to handling with a pediatric patient. More than eighty eight percent nurses comply with AC2 to AC6 which indicated their excellent skill in performing PIVC assessment every shift. However, in the AC7, only sixty seven percent comply to palpate PIVC area for any evidence of venous cord and warmth. Conclusion: This study concludes that communication between nurses and pediatric patients prior to PIVC assessment often missed out by nurses. The palpation techniques also not been carried out as compared to observation technique in pediatrics setting. Palpation technique is crucial to detect ‘warmth to touch’ because it differentiates between the early and medium stage of phlebitis.
Introduction: Promotion of internationalization of higher education is a strategic marketing in public and private Ma- laysia universities.University Malaysia Sabah (UMS) hosted the international nursing mobility programme involving 15 nursing students from Hunan and Yangtze University of China. Students from China obtained hands-on learn- ing experience and exposed to indigenous health practices in Sabah. After 12 weeks of the programme, although casual face-value audit of the mobility program was deemed adequate, there was a need to objectively gauge the Chinese student’s satisfaction and identify issue of contention that can be remedied. This study is to evaluate Chi- nese international nursing students’ satisfaction during their mobility posting tenure in UMS and identify issues of discontentment for improvement. Methods: the study entailed a cross sectional survey involving a convenient sam- ple of all 15 nursing students from China who had completed the 12-week UMS-nursing mobility programme. The study tool consisted of a 25-item questionnaire which used Likert-like statements to anchor level of satisfaction on 5 sub-domains itemsnamely; arrival orientation; logistic arrangements; learning opportunities; cultural experience and perceived worth-for-money. Results: Cumulative ratings counts from 15 Chinese international students who had participated in the UMS-nursing mobility program in this study rated the following sub-domains as satisfactory and highly satisfactory: (i) learning experience (88%), (ii) Sabah’s cultural experience (90%), (iii) worth for money (88
%). Sub-domains rated as dissatisfactory or strongly dissatisfactory by the China students were: (i) adequacy of 1st - day arrival orientation (72%), (ii) quality of logistic arrangement (72%). Conclusion: Findings imply that the China students were satisfied with the overall learning experience during the UMS-nursing mobility programme. However, areas of grievances such as the conduct of the 1st - day arrival orientation and logistics management of the UMS-mo- bility program needs to be addressed.
Introduction: Smartphone has become an essential Smart-tool for IT-based learning among university students. How- ever, excessive use of smartphones can be addictive leading to psychological distress, poor academic performance, social isolation and depression. In the context of University Malaysia Sabah (UMS), the issue of contention is whether smartphone addiction is a problem among nursing undergraduate students and thus the justification for this study. This study evaluated the pattern of usage smartphone and addiction among nursing students in UMS. Methods: The study deployed a cross-sectional survey design involving 100 (N) respondents selected through clustered convenient sampling from year 1(n=35), year 2 (n=35) and year 3 (n=30) nursing students who are currently pursuing their di- ploma study in UMS. Ethical approval was obtained from the Research Ethics Committee of UMS as well-informed consent from respondents. The study tool consisted of a well-establish validated questionnaire benchmarked from a previous study (reliability Cronbach α= 0.78) which captured respondents’ socio-demographics, smartphone us- age characteristic proforma and Smart Addiction Scale (SAS). Results: Among 100 nursing students in this study, 78% (n=78) of them had high smartphone usageaveraging 4.3 hours daily. The overall prevalence of smartphone addiction among nursing students in this study was 25% (n=25). Male student nurses significantly had higher smart- phone addiction scores compared to female students (p=0.01). Likewise, year 3 students had higher addiction scores compared to their peers in year 2 or year 1 (p=0.002). Conclusion: findings from this study imply that smartphone addiction affects 1 in 4 nursing students in UMS and there is a need to develop ‘digital detox” strategies to address the issue.
Depressive disorders are common. As compared to the general population, healthcare personnel are hypothesized to have an above than average risk to develop this condition. The aim of this study is to assess the prevalence of this condition and its contributing factors amongst primary healthcare personnel.
Methods: A cross-sectional study was conducted by universally sampling 179 primary healthcare personnel at nine primary healthcare centers across Kuala Lumpur and Selangor in May 2015. Depressive symptoms were screened using self-administered Patient Health Questionnaire-9 (PHQ-9) questionnaire. Socio-demographic and work profile data were also assessed.
Results: 92.7% of the 179 personnel agreed to participate. Near half of the respondents were staff nurses (49%), followed by doctors (22%), assistant medical officers (10%), attendants (10%) and the remaining were pharmacists, dieticians, and laboratory technicians (9%). Depression was found to be present in 38% of the participants with one-third found to have moderate to severe depression. Bivariate analysis show that males (p=0.043), assistant medical officers (p=0.048), and working more than 10 hours per day (p=0.019) are significant risk factors. Further analysis by logistic regression shows that working more than 10 hours per day increases the odds of depression by 3.1 (OR 3.1, 95% CI 1.1-8.7, p=0.03).
Conclusions: A high prevalence of depression was found within the healthcare personnel population at the primary healthcare centres studied. Being a male, employed as an assistant medical officer, and, prolonged hours at the workplace is a significant risk factor for depression.
Objectives: Occupational stress among healthcare workers is an important concern due to its crucial contribution in attaining maximum job output and optimal quality of working life. Our study aims to compare job stress levels of healthcare employees based on 1) sector, 2) category and 3) specialisation. Methods: Stress severity and frequency were evaluated using the 9-point scale Job Stress Survey (Job Stress, Job Pressure, Lack of Support). A crosssectional sample of 223 healthcare providers were enrolled from seven health institutions in Peninsular Malaysia (East Coast = 55%; mean age = 30 years; female = 78.9%; < 2 years experience = 35.9%; government-based = 48%; supportive = 62.8%). Results: No significant difference was found between government and private sector workers. Supportive staff reported significantly higher stress frequency in contrast to professionals who demonstrated significantly higher stress severity in all dimensions (p < .05). Within the supportive group, radiographers were the most stressed, followed by nurses and medical laboratory technologists (p > .05). Research-based professionals experienced significantly worse stress frequency in all components compared to professional practitioners (p < .05). Conclusion: Because stress levels are affected by job category and specialisation, flexible strategies to ensure employees’ job productivity, contentment and personal well-being should be implemented.
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.
Recent years have witnessed unprecedented changes in the design and demands of work, and the emergence of job stress as a major concern. The aim of the study was to determine the psychosocial problems in relation to nature of work among female nurses at Hospital Selayang. The study was a cross-sectional study and the study population comprised of female nurses who are currently working at Hospital Selayang. A total of 393 study subjects were randomly selected and each respondent has been given a set of complete validated self-administrated Copenhagen Psychosocial Questionnaire. The result showed that the prevalence of having psychosocial problems was 24.9%. It is show that married nurses with more than three children has 3.54 (95%CI: 1.81-6.94) higher risks to have the problems compared to those with 3 or less children. Shiftwork nurses have 1.74 (95%CI: 1.01-2.99) more risk to have psychosocial problems compared to those who are not doing shiftwork. From the crude odds ratio, nurses who have served the service for more than seven years, there was 1.53 times more risk (95%CI: 0.89-2.63) to have psychosocial problems compared to those who only have service of seven years or less. From multivariate analysis, the risk of having psychosocial problems among nurses who are doing shiftwork found to be two times greater than those who are not doing shiftwork (OR=2.15; 95%CI: 1.12- 4.11) . Psychosocial problems in relation to nature of work among nurses at Hospital Selayang are higher among nurses who are doing shdtwork. The hospital management needs to overcome the problems and organizing the mental health programs among workers.
The rapid development in the health sector has spurred many healthcare organizations to improve their productivity and quality, particularly in terms of service. Clinical Pathways was introduced with the objective of improving the quality of care and services in health; while at the same time eyeing the possibility of reducing the medical expenses. It can be defined as a document based tool that links the best available evidence and clinical practice and provides recommendations, the process and time frame for the clinical management of healthcare. A cross sectional study was carried out at University Kebangsaan Malaysia Medical Centre (UKMMC) Malaysia with the aim to evaluate the level of knowledge about Clinical Pathways (CP) and to ascertain its level of practice in the implementation of CP among healthcare workers at UKMMC; and to establish correlated determinant factors. The study involved a total of 127 respondents; majority of whom were female (77.2%), aged between 32 and 45 years (51.2%), working as nurses (71.7%), and having working experience of six years or longer (52.0%) at UKMMC. The findings reveal that 52.8% of respondents agreed that there is a proper implementation of the Clinical Pathways (CP) programme at UKMMC; and that 52.0% of the respondents have a higher level of knowledge about CP and 70.1% of them practiced it well. The findings also unravel two factors (position and working experience) as the predictors of respondents’ level of knowledge about CP, and position as a predictor representing the practice of it at UKMMC. It can be safely surmised that most of the respondents have a higher level of knowledge about Clinical Pathways and that they practice it well in their daily task as healthcare workers.
Breast self-examination (BSE) is recommended globally as one of the methods in early detection of breast cancer. Little is known about nurses screening behavior related to BSE. A cross-sectional study was conducted to examine the knowledge, attitude and practice of Breast Self Examination (BSE) among nurses. A self-administered questionnaire was sent to a total of 114 nurses working in Obstetrics & Gynaecology wards and clinics of two tertiary hospitals. Among the 114 participants, 111(97.4%) practiced BSE. The mean age of the participants was 34.97(±9.104) years. The mean score of knowledge was 11.07(±1.020) and 81.1% had high knowledge of BSE. Majority (98.2%) of respondents showed good attitude towards BSE. Barriers was found to be a significant predictor and self confidence proved to be an influencing factor on BSE performance. Despite practicing BSE, the number of nurses that examined their breast monthly was only 35.1%. Age, working experience and marital status showed no significant relationship with knowledge and practice of BSE. However, BSE taught during their undergraduate programme was found to have a significant relationship with practice of BSE. Majority of nurses in this study were not complying with MOH recommendation for BSE in terms of frequency. Thus, intervention strategies should focus on educating nurses on performing BSE monthly, in accordance with the Ministry of Health guidelines. This is important as nurses play a primary role in promoting health behaviors in BSE practice and breast cancer awareness among women in this country.
Occupational stress exists in all professions, but the nursing profession appears to experience more stress at work compared to other health care workers. Stressful conditions at the workplace may cause the high turnover and burnout among nurses. This study objective was to determine the level of stress and its associated factors among in-patient ward nurses. A cross sectional study using the stratified random sampling method was carried out among 114 staff nurses from 5 different departments in a public hospital in Kuala Lumpur. Respondents were requested to complete a single set of validated and self-administered questionnaire, the Depression, Anxiety, Stress Scale (DASS) . Data was analysed using SPSS 17. In general, the prevalence of stress at the department of Medicine was found to be higher compared to other departments studied. There was also a statistical significant relationship between the prevalence of stress and types of department (p 0.05). In conclusion, stress had no significant association with sociodemographic factors (age, marital status and financial status) and working environment except for type of department nurses work in. There might be some other possible confounders that have a bigger potential in becoming stressors compared to those independent variables in this study.
A cross-sectional study was conducted in two hospitals in Hargeisa city to determine the job and organizational stress among nurses and doctors in ICU and its influencing factors. A universal sampling method was carried out and one hundred and twenty questionnaires were distributed among nurses and doctors working in intensive care units of two hospitals on different shift duties; morning, afternoon, night and rotation shifts. The response rate was 83.3%. Regression analysis showed that approximately 88% (adjusted R square = 0.889) of the variation in stress mean score was explained by the background variables. Experience, role overload, physical environment and marital status were significant predictors.
Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry's framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child's needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
Study site: Klinik kesihatan, Tumpat, Kelantan, Malaysia
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.
Sharps injury among health care workers in HUKM has received serious attention lately due to the possible transmission of diseases like HIV, Hepatits B and Hepatitis C, which can cause serious consequences for the victim. The aim of the study was to gain a deeper understanding of the emotional problems experienced by health care workers who had incurred a sharps injury and the coping strategies adopted by them to overcome the problem. A 28 item semi-structured questionnaire was designed by the supervisors and the researcher as there was no existing questionnaire to be adopted, as no research had been carried out in this area prior to this. The target group consisted of 64 health care workers of different categories working in HUKM. Data was collected over a period of five months from November 2000 to March 2001. The results of the study revealed that the most frequently injured were the staff nurses, nearly 90% of whom were emotionally upset and were worried that they might contract a disease. There was no significant difference in the emotional stress experienced by the different categories of the health care workers, all were equally upset about the injury but each category of staff adopted different methods to overcome the tragedy. Open comments and opinions about prevention and the management of the sharps injury in HUKM as given by the respondents here are taken into account. Several views given by the participants were explored and discussed. Finally, several implications for nursing and recommendations have been presented.
Study site: Wards and the general operating theatres in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Decision making in nursing is one of the most important skills nurses must apply and utilize in their nursing practice. The aim of this study was to determine the perception of clinical decision making ability among nursing students. A descriptive cross-sectional study was conducted in a tertiary hospital. A total of 54 nursing students were recruited using a modified version of Clinical Decision Making in Nursing Scale (CDMNS) adapted from Jenkins (1985). The findings showed good CDMNS score with mean and standard deviation of (124.24±12.713). The four sub-scales of CDMNS were: searching for alternative (33.24±4.821), canvassing (28.74±3.514), evaluation and re-evaluation (31.43±3.922), searching for information (30.83±4.765). Nineteen (35%) of the participants chose nursing as their first choice, whereas 35 participants (65%) did not. Thirthy seven (69%) participants were satisfied with their nursing competency, 17 (31%) were unsatisfied. There were significant differences between searching for alternatives, evaluation and re-evaluation, and nursing as their first choice (p=
Study site: Nursing students, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Patient satisfaction plays a crucial role in ensuring utilization of healthcare services, continuity of care, and compliance towards treatment. Thus, this study aimed at determining the level of patient satisfaction with the services provided by the UKMMC primary care clinic. A descriptive cross-sectional study involving 317 patients attending the clinic from February to March 2011 was carried out. They were selected through systematic random sampling. Using a validated self-administered Patient Satisfaction Questionnaire-46 (PSQ-46) in English and Malay versions, general satisfaction and satisfactions with five different subscales (doctors, nurses, accessibility, facilities and appointment) were assessed. A majority of the patients (93.1%) were generally satisfied with the overall services. Among the five subscales, patients were most satisfied with the doctors (96.5%), but only 35.6% of the patients were satisfied with the facilities. The proportions of patients who were satisfied with other subscales were: 86.1% (appointment), 82.0% (nurses) and 68.1% (accessibility). There was a significant association between each of the subscales and the general satisfaction (p
The working environment of intensive care unit (ICU) nurses is a constant source of stress. Researchers have described ICU as a stressful environment because of the complex nature of patients’ health problems requiring an extensive use of very sophisticated technology. This study aimed to identify the prevalence of stress among staff nurses working in ICU, Hospital Universiti Kebangsaan Malaysia (HUKM), factors influencing stress and to explore the symptoms of stress experienced. This descriptive study was conducted on 67 staff nurses working in ICU, HUKM. Data was collected using self-administered questionnaires. The questionnaires included sections on socio-demographic data, factors influencing stress and symptoms of stress experienced. Data was analyzed using frequency and percentage. The Chi square test was used to examine the relationship between socio-demographic data and factors influencing stress. Findings indicated that stress symptoms were experienced by 100 per cent (n =67) of staff nurses Knowledge, working experience, critically ill patients, and environmental factors were one of the many factors contributing to the stress experienced by the ICU nurses in HUKM. Nurses working in ICU, HUKM are found to have a high level of stress. Recommendations like encouraging ICU nurses to take up post basic ICU courses and increasing the nurses quota can reduce the prevalence of stress among ICU nurses. Hospital management has an important role to play in reducing the stress levels of nurses working in ICU as stress has an effect on job performance and quality of nursing care.
Patient education has been considered as an integral component of care for patient after myocardial infarction. Post myocardial infarction patients require information and knowledge related to their conditions to reduce anxiety and aid recovery. The objective of this study was to identify nurses’ perception on information needs of post MI patients of UKMMC. A cross sectional study using Cardiac Patient Learning Needs Inventory (CPLNI) adopted from Timmins and Kalizer (2002) was used. It comprises seven cate-gories: related to anatomy and physiology, psychological factor, life style factor, medi-cation information, dietary information, physical activity, and symptom management. This study was conducted in coronary care unit (CCU), coronary rehabilitation ward (CRW), medical ward 1 and medical ward 2 from January 2007 to March 2007. 56 res-pondents (96%) who fulfilled the inclusion criteria were recruited in this study. Results showed that CCU and CRW respondents ranked symptom management as their first ranking followed by medication, life style factor, anatomy and physiology, dietary in-formation, physical activity and psychological factor. However, respondents in Medical Ward 1 and 2 reported and ranked medication information as their top priorities fol-lowed by symptom management, psychological factors, dietary information, physical activity, anatomy and physiology and life style factor. There were significant differ-ences between ward nurses’ responses with their perception related to anatomy and physiology, psychology factor, life style factor, physical activity, and symptom man-agement with p value
Drug administration is an integral part of nurses role in nursing practice. In relation to their diverse roles, nurses are required to have adequate knowledge and good practice. The purpose of this study is to examine the level of knowledge, attitude and practice of nurses in the medical wards administering oral medication and to assess whether nurse’s knowledge, attitude and practice is associated with working experience and professional education (post basic training). A cross-sectional study was conducted on forty (40) nurses working in the Medical wards in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Questionnaires were used to measure the level of knowledge and attitude of nurses and a direct observation technique with checklist to record the practice of nurses. The mean score for knowledge (13.8), attitude (16.4) and practice (10.7) were all within average distribution. No significant difference was found between knowledge and practice of nurses with working experience and post basic training. However, the influence of working experience on attitude of nurses in serving oral medication was found to be significant (p= 0.045). Nurses in medical ward, Universiti Kebangsaan Malaysia Medical Centre, were found to possess an average level of knowledge and attitude in administering oral medication. In addition, this study suggest that work experience of nurses has no influence on knowledge gain and good practice in administering oral medication..