METHODOLOGY: This was a cross-sectional observational study done from November 2017 until December 2017 at ED Hospital Sultan Abdul Halim (HSAH), a 650-bedded tertiary hospital in the state of Kedah. All patients that were triaged to red zone, age 18 years and above, and involved in intra-hospital transfer to critical coronary unit, intensive care unit and wards were included. All cases were documented in proforma by the accompanying staff.
RESULTS: Among the 170 critically ill patients, only 29 patients (17.1%) experienced adverse events during intra-hospital transfer. The adverse events seen were hypotension (12.4%), desaturation (3.5%) and dislodged peripheral line (2.4%). Cardiorespiratory related diagnosis was the commonest presentation. Intra-hospital transfer during morning shift and evening shift has 79.5% (b=-1.59, OR=0.21, 95% CI: 0.06, 0.69, p=0.011) and 75.6% ((b=-1.41, OR=0.24, 95% CI: 0.08, 0.73, p=0.012) lesser odds of experiencing adverse events compare to night shift. Patients with vasopressor/inotropes had 9 times higher odds of experiencing adverse events during transportation, compared to patients with no vasopressor/inotropes (b=2.27, OR=9.70, 95% CI: 3.39, 27.72, p<0.001).
CONCLUSIONS: Critical care patients who are involved in intrahospital transfer were at risk of adverse events such as hypotension, desaturation and dislodge peripheral line. Risk identification and maintaining level of care is important to minimize the adverse events during transfer. Patients had higher rates of adverse events if they were transferred during night shifts and on inotropic/vasopressor support.
MATERIALS AND METHODS: This was a quantitative crosssectional study conducted from November 2020 until March 2021 which involves 139 HBCD caregivers in Kelantan. Validated questionnaire was used which consisted of 27 questions based on demography, knowledge and attitude towards CPR. The data was keyed in and analysed using software SPSS version 26.
RESULTS: A total of 139 respondents participated in the study. The mean attitude score obtained by the caregivers was 16.67 with SD = 4.22. There were 89 caregivers (64%) with poor knowledge among the 139 HBCD caregivers in the study compared to 50 HBCD caregivers (36%) who had good knowledge. Caregivers who were exposed with CPR training had 5.91 higher odds of having good CPR knowledge compared to those without being exposed to CPR training (Wald-statistic (df) = 21.12 (1), OR (95% CI) = 5.91 (2.77, 12.61), p<0.001). Caregivers with experience in handling CPR were 5.91 of higher odds in having good CPR knowledge compared to those without the experience in handling CPR when adjusted for the duration of caregiver's experience (Wald-statistic (df) = 21.12 (1), OR (95% CI) = 5.91 (2.77, 12.61), p<0.001). HBCD caregivers' experience was the only variable that had a significant p-value when tested in the regression model (p = 0.023).
CONCLUSION: The findings revealed that HBCD caregivers in Kelantan had inadequate CPR knowledge, potentially increasing the risk of OHCA. Planned and regular training for them is mandatory. Exposure to CPR was the associated factor that contributes to knowledge level among HBCD caregivers whereas years of experience as HBCD caregivers influence attitude towards CPR.