Displaying all 11 publications

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  1. Alkhawaldeh JMA, Soh KL, Mukhtar FBM, Peng OC, Anshasi HA
    Nurs Crit Care, 2020 03;25(2):84-92.
    PMID: 31840391 DOI: 10.1111/nicc.12489
    BACKGROUND: The level of occupational stress of nurses working in intensive and critical care units is high. Although many studies have assessed the effectiveness of stress management interventions among intensive and critical care nurses, the methodological quality of these studies remains unclear.

    PURPOSE: The purpose of this review was to summarize and appraise the methodological quality of primary studies on interventions for management of occupational stress among intensive and critical care nurses.

    METHODS: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify primary studies that assessed the effectiveness of interventions in managing occupational stress among intensive and critical care nurses using multiple databases from January 2009 to June 2019.

    RESULTS: Twelve studies published between 2011 and 2019 were eligible for inclusion. These included studies were classified as being of good or fair quality. The consensus across the included studies was that, compared with control condition, cognitive-behavioural skills training and mindfulness-based intervention were more effective in reducing occupational stress among intensive and critical care unit nurses.

    CONCLUSION: Further research should focus on methodologically strong studies by blinding the outcome assessors, using Randomized Controlled Trial (RCT) design with an active control group, using standardized assessment tools, and reporting enough details about the stress management intervention-related adverse events.

    RELEVANCE TO CLINICAL PRACTICE: This review demonstrates the need for high methodological quality studies to rigorously evaluate the effectiveness of stress management interventions before it can be recommended for use in clinical practice to reduce stress in intensive and critical care unit nurses. In addition, attention should be given to developing research protocols that place more emphasis on interventions aimed at the organization level to address the growing problem of occupational stress among intensive and critical care nurses.

    Matched MeSH terms: Critical Care Nursing*
  2. Poh PF, Sng QW, Latour JM, He L, Fong MF, Muralidharah J, et al.
    Pediatr Crit Care Med, 2022 Nov 01;23(11):e498-e506.
    PMID: 35834674 DOI: 10.1097/PCC.0000000000003023
    OBJECTIVES: To identify nursing research priorities in pediatric critical care in Asia.

    DESIGN: We conducted a modified three-round eDelphi survey with pediatric critical care nurses in Asia. The eDelphi technique has been extensively used within health research to achieve a common viewpoint from experts using questionnaires to gather research priorities. In round 1, participants were asked to list three to five research topics that they deemed important. These topics were thematically analyzed and categorized into a questionnaire. Participants rated the research topics in round 2 on a 6-point scale (1 = not important to 6 = extremely important). In round 3, the same questionnaire was used with addition of the calculated mean scores from round 2 for each topic. Research topics ranked among the top 10 were considered extremely important.

    SETTINGS: Twenty-two PICUs in eight Asian countries.

    SUBJECTS: Clinical nurses, managers, educators, and researchers.

    INTERVENTIONS: None.

    MEASUREMENTS AND MAIN RESULTS: In round 1, 146 PICU nurses across eight countries provided 520 research topics. Topics from round 1 were categorized into seven domains with 52 research topics. Prioritized research topics included early recognition of patient deterioration (mean 5.58 ± 0.61), prevention of healthcare-associated infections (mean 5.47 ± 0.70), and interventions to reduce compassion fatigue (mean 5.45 ± 0.80). The top three research domains were end-of-life care (mean 5.34 ± 0.68), professionalism (mean 5.34 ± 0.69), and management of pain, sedation, and delirium (5.32 ± 0.72).

    CONCLUSIONS: This first PICU nursing research prioritization exercise within Asia identified key nursing research themes that should be prioritized and provide a framework for future collaborative studies.

    Matched MeSH terms: Critical Care Nursing*
  3. Lean Keng S, AlQudah HN
    J Adv Nurs, 2017 Feb;73(2):465-481.
    PMID: 27601180 DOI: 10.1111/jan.13142
    AIMS: To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery.

    BACKGROUND: The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan.

    DESIGN: Two-phase mixed methods sequential explanatory design and grounded theory.

    SETTING: critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20).

    METHODS: Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis.

    RESULTS: Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance.

    CONCLUSION: There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making.

    Matched MeSH terms: Critical Care Nursing/methods*; Critical Care Nursing/standards
  4. Ludin SM
    Intensive Crit Care Nurs, 2018 Feb;44:1-10.
    PMID: 28663105 DOI: 10.1016/j.iccn.2017.06.002
    BACKGROUND: A critical thinker may not necessarily be a good decision-maker, but critical care nurses are expected to utilise outstanding critical thinking skills in making complex clinical judgements. Studies have shown that critical care nurses' decisions focus mainly on doing rather than reflecting. To date, the link between critical care nurses' critical thinking and decision-making has not been examined closely in Malaysia.

    AIM: To understand whether critical care nurses' critical thinking disposition affects their clinical decision-making skills.

    METHOD: This was a cross-sectional study in which Malay and English translations of the Short Form-Critical Thinking Disposition Inventory-Chinese Version (SF-CTDI-CV) and the Clinical Decision-making Nursing Scale (CDMNS) were used to collect data from 113 nurses working in seven critical care units of a tertiary hospital on the east coast of Malaysia. Participants were recruited through purposive sampling in October 2015.

    RESULTS: Critical care nurses perceived both their critical thinking disposition and decision-making skills to be high, with a total score of 71.5 and a mean of 48.55 for the SF-CTDI-CV, and a total score of 161 and a mean of 119.77 for the CDMNS. One-way ANOVA test results showed that while age, gender, ethnicity, education level and working experience factors significantly impacted critical thinking (p<0.05), only age and working experience significantly impacted clinical decision-making (p<0.05). Pearson's correlation analysis showed a strong and positive relationship between critical care nurses' critical thinking and clinical decision-making (r=0.637, p=0.001).

    CONCLUSION: While this small-scale study has shown a relationship exists between critical care nurses' critical thinking disposition and clinical decision-making in one hospital, further investigation using the same measurement tools is needed into this relationship in diverse clinical contexts and with greater numbers of participants. Critical care nurses' perceived high level of critical thinking and decision-making also needs further investigation.

    Matched MeSH terms: Critical Care Nursing/manpower; Critical Care Nursing/standards*
  5. Darsin Singh SK, Ahmad A, Rahmat N, Hmwe NTT
    Nurs Crit Care, 2018 Jul;23(4):186-191.
    PMID: 27071369 DOI: 10.1111/nicc.12240
    BACKGROUND: Coronary heart disease has emerged as a number one killer in Malaysia and globally. Much of the morbidity and mortality in acute coronary syndrome patients is because of patients not recognizing their symptoms which contributes to delay in seeking early treatment.

    AIM: The aim of this study is to evaluate the effectiveness of a nurse-led health education programme on knowledge, attitude and beliefs of coronary patients towards the responses to acute coronary syndrome and the association with patients' characteristics.

    METHODS: A single-group quasi-experimental design took place in a tertiary hospital. A total of 60 coronary patients were recruited to this study. The knowledge, attitude and beliefs towards acute coronary syndrome (ACS) were evaluated at baseline and after 1 month of giving education intervention.

    RESULTS: Knowledge, attitude and beliefs about ACS increased significantly from baseline to 1 month after intervention. Level of attitude was associated with gender, educational level and employment status.

    CONCLUSIONS: The findings of this study suggest that an education program conducted by a nurse improved patients' level of knowledge, attitudes and beliefs in response to ACS symptoms at 1 month compared to baseline, but whether they are sustained for a longer period is unclear. Improving the responses towards ACS might reduce decision delay in symptom interpretation and seeking early treatment.

    RELEVANCE TO CLINICAL PRACTICE: Nurse-led interventions have imparted positive outcomes in response to ACS symptoms among coronary patients. Therefore, nurses should take the initiative in educating patients to minimize delay in symptom interpretation and seeking early treatment.

    Matched MeSH terms: Critical Care Nursing*
  6. Guo P, Chiew YS, Shaw GM, Shao L, Green R, Clark A, et al.
    Intensive Crit Care Nurs, 2016 Dec;37:52-61.
    PMID: 27401048 DOI: 10.1016/j.iccn.2016.05.003
    Monitoring clinical activity at the bedside in the intensive care unit (ICU) can provide useful information to evaluate nursing care and patient recovery. However, it is labour intensive to quantify these activities and there is a need for an automated method to record and quantify these activities. This paper presents an automated system, Clinical Activity Tracking System (CATS), to monitor and evaluate clinical activity at the patient's bedside. The CATS uses four Microsoft Kinect infrared sensors to track bedside nursing interventions. The system was tested in a simulated environment where test candidates performed different motion paths in the detection area. Two metrics, 'Distance' and 'Dwell time', were developed to evaluate interventions or workload in the detection area. Results showed that the system can accurately track the intervention performed by individual or multiple subjects. The results of a 30-day, 24-hour preliminary study in an ICU bed space matched clinical expectations. It was found that the average 24-hour intervention is 22.0minutes/hour. The average intervention during the day time (7am-11pm) is 23.6minutes/hour, 1.4 times higher than 11pm-7am, 16.8minutes/hour. This system provides a unique approach to automatically collect and evaluate nursing interventions that can be used to evaluate patient acuity and workload demand.
    Matched MeSH terms: Critical Care Nursing/manpower
  7. Mortell M, Abdullah KL, Ahmad C
    Br J Nurs, 2017 Sep 28;26(17):965-971.
    PMID: 28956990 DOI: 10.12968/bjon.2017.26.17.965
    AIM: To explore the perceptions of patient advocacy among Saudi Arabian intensive care unit (ICU) nurses.

    BACKGROUND: Despite advocacy being a crucial role for nurses, its scope is often limited in clinical practice. Although numerous studies have identified barriers to patient advocacy, their recommendations for resolution were unclear.

    METHOD: The study employed a constructivist grounded theory methodology, with 13 Saudi Arabian registered nurses, working in critical care, in a tertiary academic teaching hospital. Semi-structured interviews, with broad open-ended questions, and reflective participant journals were used to collect data. All interviews were concurrently analysed and transcribed verbatim.

    RESULTS: Gender, culture, education, subjugation, communal patronage, organisational support and repercussions, and role-associated risks were all revealed as factors affecting their ability to act as advocates for critically ill patients.

    CONCLUSION: Saudi Arabian ICU nurses in the study believed that advocacy is problematic. Despite attempting to advocate for their patients, they are unable to act to an optimal level, instead choosing avoidance of the potential risks associated with the role, or confrontation, which often had undesirable outcomes. Patient advocacy from a Saudi Arabian nursing perspective is contextually complex, controversial and remains uncertain. Further research is needed to ensure patient safety is supported by nurses as effective advocates.

    Matched MeSH terms: Critical Care Nursing*
  8. Siti Aminah Ismail, ZakiraMamat @ Mohamed, Nik Hisamuddin Nik Ab. Rahman, Nur Syahmina Rasudin
    MyJurnal
    Introduction: The east coast hospitals of Malaysia are regularly stricken by flood disaster and nurses make up the majority of frontline responders in disaster. So, they should equip themselves with knowledge and skills related to disaster management. The objective of this study was to explore the factors associated with attitude and practice in disaster management among critical care nurses in the east coast hospitals of Malaysia. Methods: This was a quanti- tative study with a descriptive cross-sectional study design that were involved 250 critical care nurses from the east coast hospitals of Malaysia by used stratified random sampling method. Data were collected by using a validated questionnaire. Multiple logistic regression analysis was used to determine the factors associated with attitude and practice in disaster management. Results: A majority of the critical care nurses had a positive attitude (92.4%, n=231) and adequate practice (80%, n= 200) in disaster management. Among the selected factors studied, attending disaster training/ education was significantly associated with attitude (AOR 4.23, 95% CI: 1.474, 12.144, p = 0.007) and practice (AOR 4.203, 95% CI: 2.102, 8.402, p = 0.000). Disaster response experience had a significant association with practice (AOR 2.697, 95% CI: 1.122, 6.479, p = 0.027) but no significant association with attitude. Level of education, years of service and workplace showed no significant association with attitude and practice in disaster management. Conclusion: This study revealed that disaster training/ education was one of the factors that would ensure positive attitude and adequate practice in disaster management among critical care nurses in the east coast hospitals of Malaysia. Therefore, it is recommended for disaster management programme to be included in continu- ing education training for critical care nurses to ensure them to be well-prepared and respond competently when disaster happen.
    Matched MeSH terms: Critical Care Nursing
  9. Chung Su Chin, Pauline Stitt
    MyJurnal
    Introduction: During resuscitation efforts, patients’ families are routinely barred from the resuscitation area. Even there is an increased in demand from the family members requesting to be present during resuscitation of their loved one, health care providers not always offer the option for family presence. The major concerns of health care providers who are opposed to family presence during resuscitation (FPDR) were fear of psychological trauma to family members who witnessed the resuscitation. This study aimed to examine the critical care nurses’ perception and attitudes towards the presence of patients’ family members during resuscitation in adult critical care units. Methods: Study papers included were narrowed to primary study, published within 2003-2014, describing nurses’ perceptions and attitudes on an adult inpatient family witnessed resuscitation in critical care units. Results: Seven studies included, and four main themes emerged mainly samples population, nurses’ experiences of FPDR, nurses’ responses toward FPDR and factor predicting nurses’ attitudes toward FPDR. 20% - 42.2% of nurses had experienced FPDR. Only 4% - 6% of study participants working in hospital with established policy and 95% - 100% had not invited family members to witnessed resuscitation. Nurses would consider the option if family members are accompanied by trained staff. Nurses concern included difficult to concentrate, negatively affecting their per- formance, increased rate of legal action, inadequate staff and limited space. Concerns on family members included too distressing event, negative psychological impact argue and interfere with staff. Concerns on patient would be breach of confidentiality. Conclusion: Adult critical care nurses demonstrated negative perceptions and attitudes towards FPDR. Study participants in this review are not familiar with the concept of FPDR. There is a need for policy development and education on FPDR.
    Matched MeSH terms: Critical Care Nursing
  10. Atefi N, Abdullah KL, Wong LP
    Nurs Crit Care, 2016 Jan;21(1):8-17.
    PMID: 25270664 DOI: 10.1111/nicc.12100
    BACKGROUND: Job satisfaction is an important factor in health care settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. However, there have not been any studies exploring the job satisfaction of Malaysian nurses.

    AIM: The main purpose of this qualitative descriptive study was to explore the factors related to feelings of job satisfaction as well as job dissatisfaction experienced by registered nurses in Malaysia.

    METHOD: A convenient sample of 46 Malaysian nurses recruited from a large hospital (number of beds = 895) participated in the study. A total of seven focus group discussions were conducted with nurses from surgical, medical and critical care wards. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. The transcripts were used as data and were analysed using a thematic approach.

    FINDING: The study identified three main themes that influenced job satisfaction: (1) nurses' personal values and beliefs; (2) work environment factors and (3) motivation factors. Concerning the nurses' personal values and beliefs, the ability to help people made the nurses felt honoured and happy, which indirectly contributed to job satisfaction. For work environment factors, team cohesion, benefit and reward, working conditions play an important role in the nurses' job satisfaction. Motivation factors, namely, professional development and clinical autonomy contributed to job satisfaction.

    CONCLUSION: It is important for nurse leaders to provide more rewards, comfortable work environments and to understand issues that affect nurses' job satisfaction.

    RELEVANCE TO CLINICAL PRACTICE: Our findings highlight the importance of factors that can improve nurses' job satisfaction. The study provides basic information for hospital administrators in planning effective and efficient policies to improve nursing job satisfaction in order to increase the quality of patient care and decrease nursing turnover.

    Matched MeSH terms: Critical Care Nursing
  11. Ho SE, Ho CC, Hng SH, Liu CY, Jaafar MZ, Lim B
    Clin Ter, 2013;164(5):407-11.
    PMID: 24217826 DOI: 10.7417/CT.2013.1604
    Hand hygiene is the most important measure in the prevention of healthcare-associated infections (HCAI). Adherence to hand hygiene protocols in hospital by nurses enables in prevention and control the HCAI. The main aim of the present study was to assess nurses' compliance to hand hygiene practice and knowledge in a hospital.
    Matched MeSH terms: Critical Care Nursing
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