Objective: In 2014, Malaysia suffered a severe flood disaster and many people lost their home and belongings. Despite regular flooding in this area, the status of community disaster resilience (CDR) is unknown. This paper thus aims to assess the association between demographic characteristics and community disaster resilience factors.
Methods: A cross-sectional study was completed using the Conjoint Community Resiliency Assessment Measure (CCRAM28) questionnaire six months after the flood event occurred. All selected respondents who met the inclusion criteria were recruited, and IBM SPSS software was used to undertake descriptive and inferential analysis.
Results: A total of 386 respondents completed the questionnaires. Respondents were mostly female (57%); married (83.9%); with children under 17 years old (58.8%); from villages or rural area (97.2%); living in basic housing (95.6%); of average income; Muslim (97.5%); educated to primary or secondary level (81.1%); and not involved with any community organizations (95.1%), including volunteering, emergency teams, or military service. The mean age was 49 years, and length of time living in the area ranged from 1 to 85 years. CDR scores ranged between medium (2.34- 3.66) and high (3.67- 5.00). An analysis of the results showed that only gender (p = 0.003) and education (p = 0.001) were significantly related to CDR level. Positive and strong correlations were seen between resilience factors, however, particularly leadership (p = 0.001), collective efficacy (p = 0.001); preparedness (p = 0.001); place attachment (p = 0.001); and social trust (p = 0.001).
Conclusion: The study provides a timely insight into the impact of demographic characteristics and resilience factors in Kelantan, developing the knowledge base needed to create comprehensive, improved community-relevant strategies for the future. This assessment enables top-down initiatives to better understand resilience levels, and this could act as tool to enable the government to prepare communities for future disasters or emergency events.
Objective: International studies show that ICU outreach services help to improve patients' condition and reduce both the length of hospital stays and mortality rates. However, Malaysian nurses’ perceptions of ICU outreach services and their implementation have previously remained uninvestigated. This study thus aims to uncover Malaysian nurses’ perceptions of implementing Intensive Care Unit (ICU) outreach services.
Method: An exploratory mixed method was used, focusing on 47 Malaysian hospital ICU nurses, using surveys and interviews over a 2-month period in 2015. All those who met the inclusion criteria were purposively recruited into the study.
Results: A total of 47 respondents completed the questionnaires. The mean years of employment was 9.72 and mean age was 33.6 years. Only seven respondents had undertaken an intensive care course and had knowledge of ICU outreach services. Years of employment and highest education level were not significantly related to awareness of ICU outreach services. Major themes emerging from the interviews included ICU outreach service benefits, ICU readmission events, and nurses’ readiness for ICU outreach services. Interview data supported the survey results consistently.
Conclusion: Nurses are aware of the advantages of ICU outreach services for both nurses and patients, despite the fact that there is no official implementation of such services in Malaysia. Their appreciation of the importance of ICU outreach services, and enthusiasm to participate in a new program to improve ICU survivors’ condition and care in general wards, indicates the potential for better care in the future.
Background:The challenge of recognizing ward-based patients at risk of deterioration is discussed
frequently within the relevant literature. Nurses in particular hold the prime position to identify problems at
an early stage using systematic patient assessment. However, general ward nurses' perceived knowledge,
attitudes, and practice related to assessment of the risk of deterioration are not well understood. Failures to
recognize or act upon the deterioration of general ward patients has sometimes resulted in the implementation
of early warning scoring systems and Critical Care Outreach teams.
Aim: The study aim to explore general ward nurses' perceived knowledge, attitude, and practice (KAP) in
assessing patients at risk of deteriorating in general wards.
Method: ACross-sectional study design with Modified Early Warning Score questionnaire for general ward
nurses was done in one tertiary hospital in Malaysia in 2013 and 2014.
Results: General ward nurses perceived that they struggled with knowledge and attitude, but they feel they
performed good practice in assessing patients at risk for deterioration. Nevertheless, the study finding shows
otherwise. Only one respondent achieved 'grade B' (85%) and the remainder scored in the band 'grade F'
(very poor). The respondents' attitude was measured by their perception of their levels of confidence and
concern. The mean confidence level was greater than six out of 10 for all categories. The attitudes mean score
± SD was set at 42.02 ±7.76. The data showed that 51% (N=50) scored below mean core of 42.02. However,
participants' overall mean score ±SD for perceptions of practice (risk of deterioration assessment) was 90.27
± 21.87 (6.94+/-1.683). The majority of participants awarded themselves a score between eight and nine,
which is in the 'good' range for the scale (0-2 weak; 3-5 moderate; 6-8 good; 9-10 excellent). Those who
scored above it were classified as having a good attitude.
Conclusion: A need exists for general ward nurses to gain a knowledge foundation in detecting abnormality
to address lack of confidence, poor attitude and alertness, and concern.
Objective: This paper reports the medical record analysis findings to identify nurses and junior doctors risk assessment and response to the incidence of deteriorating patient in general ward. Methods: A medical records analysis was conducted at a medical ward in one Malaysian hospital. Patients that were admitted for more than 24 hours and scored at least 3 points on the Modified Early Warning Sign (MEWS) assessment with their last 24 hours parameters calculated and nurses and junior doctor’s responses were analysed retrospectively. Results: Out of 200 records obtained, only 10 patients’ medical records met the study inclusion criteria. Three main themes were evident in the study, namely ‘track and trigger’, ‘hierarchical intervening’ and ‘attitude’. Conclusion: This study demonstrates that some nurses and junior doctors experience difficulties in effectively responding to patient deterioration which often occurs at a critical juncture. This study highlights factors which need to be addressed to increase patient safety and improve medical outcomes during hospitalization.