Introduction: General Hospital`s Emergency Departments (ED) have become focal points for individuals presenting with mental health problems seeking help. However, frontline ED nurses and Assistant Medical Officers (AMOs) often lack the skills and competency to effectively triage and manage clients presenting with a myriad of psychiatric issues. The objective of the study is to assess ED nurses & AMOs ’s perceived competency and associated factors in providing care for clients presenting with psychiatric concerns. Methods: This study is a quantitative, cross-section- al survey design. One hundred and forty-six ED nurses & AMOs were recruited from two tertiary general hospitals in Kota Kinabalu by random sampling. A validated tool (α = 0.92), the Behavior Health Competency Care (BHCC) questionnaire was used to measure psychiatric care competency among participants. Data analyses used descrip- tive and inferential statistics to identify the association of respondent’s work setting, designation, age, years of work experience, qualification with competency scores. Findings: low total mean score of 2.52(SD 0.68) was found in perceived psychiatric competency among ED nurses & AMOs. Other findings indicate, low perceived competence in risk assessment and poor ability to provide intervention for clients presenting with acute psychiatric conditions. Con- clusion: This study found major gaps in psychiatric care competency among ED nurses & AMOs. As ED`s of general hospitals continue to be a focal point for clients with psychiatric disorders seeking help, competency shortfall among frontline ED nurses & AMOs, will negatively affect the quality of psychiatric care delivery and needs to be addressed.
Introduction: One of the aims outlined in Malaysia’s Health Vision 2020 is to be a nation of healthy individuals, families, and communities through an equitable, affordable, efficient, environmentally adaptable, and consumer friendly healthcare system. Sabah faces tremendous challenges to provide the best care for patients. For example, Sabah's unique geographical location and landscape, such as steep hills and rivers, is one of the challenges that health staff faces. Objectives of this study aimed to examine the prevalence of geographical accessibility, types of healthcare services, and the types of health seeking behaviour in 2 northern rural areas of Sabah to assess the geographic accessibility and availability of healthcare services.
Materials and Methods: A community-based cross-sectional study was conducted in two rural areas in Sabah—Kudat and Pitas. Data collection was done by using questionnaire and face–to-face interviews
Results: It was found that 48% of the study population sought healthcare and they mainly chose healthcare services from hospitals and health clinics.
Conclusion: Half of the population in the areas studied used healthcare in the last year. The choice of using a public hospital or community health clinics was determined by distance from residence
Introduction: Psychiatry posting is one of essential posting for medical students in Universiti Malaysia Sabah. Apart from learning about mental health disorder, students are also exposed to various psychotherapies techniques are crucial in psychiatric practise. However, in view of COVID-19, online learning had to be adopted, instead of the traditional face-to-face learning. Methods: The study aimed to assess the difference in diverse psychological constructs, such as psychological mindedness, flexibility, and mindfulness; pre-&post-psychiatry posting, and to determine whether online learning was comparable to face-to-face learning. The study was done on58 undergraduate medical student populations, utilizing a set of scales to determine the psychological constructs, viz.,balanced Index of psychological mindedness, Leeds attitudes to Concordance Scale II (LATCon II), the mindful attention awareness scale, and the acceptance and action questionnaire-II, which were administered before &after completion of the posting. Results: Results were subsequently analysed using IBM SPSS. Interestingly, both control group (mean difference= 15.155, p= 0.004) and online psychiatry posting (mean difference 12.691, p= 0.014) had higher mindfulness level when compared to face-to-face psychiatry posting. Despite the common perception that psychiatry posting raises awareness regarding mental health, it was found that there were no significant differences in psychological constructs pre-and post-psychiatry posting. Interestingly, the online psychiatry posting also found to be as effective as the face-to-face psychiatry posting. Conclusion:This study highlighted the applicability of online learning in psychiatry, which could be crucial in maintaining continuity of learning during these uncertain times
Introduction: Collaborative working culture is an important milestone to be inculcated in a hospital setting. In the process of preparation for the upcoming teaching hospital of Universiti Malaysia Sabah (HUMS), the organisational value of innovative, collaborative, compassionate, empowering, and sustainable needs to be inculcated to the both management and clinical staffs. The objective of this study was to assess the efficacy of a collaborative practise workshop in staff. Methods: A two days experiential learning workshop was conducted to deliver and inculcate the organisational value of HUMS to 32 existing and newly recruited healthcare professionals, which include doctor, nurses, assistant medical officer, dental assistant, pharmacist, and radiographer. The topics consisted of principles of collaborative practice, skill of validation, feedback-giving method, approach for value identification and goal setting, reflective practice, public communication during crisis, shared decision making, and organisational problem solving. Different delivery methods include round table discussion, role play, and group work were used. Innovative real time practice of giving feedback to the management was performed directly to the hospital chief executive officer and chief clinical officer. Results: Immediate feedback from the participants found that the candidates found the course was enriching and it helped them to develop an alternative perspective on how to get work done. The staffs expressed their idea, concern, and expectation more openly with the method learned using what they had learnt. The limitation included the challenge of transition from previous working culture to new environment without further supervision. Conclusions: Further systematic evaluation using more detailed assessment tool is needed to understand the long term efficiency and translatability of the learning outcomes into clinical practice once the hospital is ready.
Introduction: Continuous quality improvement of system is essential to improve efficiency of working environ- ment. Limited financial allocation in low resource setting results in the vicious circle of having inadequate money to purchase a new system and print paper documents that are required for the operation of clinic. A staff-initiated system improvement with the name of “PRW UMS Staff Portal” was attempted to break-free from the vicious cycle. Methods: An online system covering different aspects of routine clinical work of healthcare workers was created in Dec 2019 and implemented in Feb 2020 using Google SiteTM by the nurses of a local university community clinic, which included: submission of daily reports of nurses and assistant medical officers, submission of reports of all programmes conducted by the clinic, surveillance of health status of working staffs, announcement and request of working roster, archiving of documents, and medication inventory. The system could only be accessed using official working email for general documents while accesses to sensitive documents were restricted to relevant staffs to pro- tect privacy and confidentiality of information. Qualitative interviews were performed with all nursing staff involved. Results: Qualitative feeling of improvement in coordination of workflow was reported by all 23 staffs working in the clinic in view of the easy access of system using smartphone and computer at workstation. It also reduced the need to move away from the working station in order to access, replenish, or submit the printed documents and reports. Significant amount of paper and printing were saved monthly. Conclusions: Despite positive feedback from the staffs, the system requires further improvement in terms of function and security. Further evaluation on cost-efficiency of the system can be done to promote the system to other universities.
Introduction: Crisis communication is an important skill for healthcare professionals, especially during disaster peri- od including the current 2019-nCoV pandemic. Nevertheless, the skill of crisis communication is not commonly an integral part of Malaysian nursing diploma and degree course. Methods: A half days session on how to communicate in the context of crisis was incorporated into an experiential learning workshop to 25 existing and newly recruited nurses together with 7 other healthcare professionals. The topics of nature of disaster, disease outbreak, preparation for disaster, principles and responsibility of crisis communication, preparing statement for press conference, and corporate communication were covered through brief lecture, round table discussion and tabletop simulations. Real time example of 2019-nCoV crisis communication was used to illustrate the skills required in the situation. Results: All participants confirmed that this was the first exposure to hands-on training on crisis communication and enlightening although majority of them were uncertain that they are capable to perform it during the crisis despite the ongoing 2019-nCoV issue in view of their the position that they are holding. Most nursing curriculums focus on clinical theory and clinical skill competency acquisition without addressing the need of learning how to commu- nicate beyond clinical setting in the situation of disaster and panic, which is mostly learned at job. The limitation included the practice in tabletop simulations might not be immediately translatable into real life practice. Conclu- sion: Regular reinforcement through more workshops and incorporation into disaster may potentially be a solution to improve the competency of healthcare professionals in crisis communication. Further assessment on the practice of the participants in performing crisis communication is needed to ensure the competency level has been achieved and to evaluate the efficiency of the workshop delivery method.