Authors: Chia Yen Low, QingJun Cheang, Pek Hong Lim.

ABSTRACT

Background: Clinical teaching is an important and essential teaching tool in the clinical area. Clinical teaching and learning is essential for the development and progression of experiential nursing knowledge.

Objectives: This research study aims to identify the perceptions and evaluations regarding clinical teaching among Year 2 and Year 3 nursing students, and also to find out if there are any differences in the perceptions and evaluations of the nursing students in regards to clinical teaching.

Methods: The formula for calculating the sample size was adopted from Morris (2005). The sample size obtained from the calculation with the confidence interval of 95%, was 132 participants. The participants were taken from a universal population of 142 diploma nursing students: 50 Year 2 nursing students and 92 Year 3 nursing students from the International Medical College in Selangor. The research instrument used was the Bedside Teaching Evaluation questionnaire that was adapted with approval by the writer from the University of Witwatersr and Department of Surgery (2008). A pilot study was conducted on 20 participants of Year 1 to Year 3 nursing students from the Assunta College of Nursing, with a Cronbach’s alpha reliability index of 0.89.

Results: The data collected were analysed using descriptive statistics to find out the participant’s perceptions and evaluations regards clinical teaching; and also to compare the perceptions and evaluations between the two groups of nursing students from Years 2 and 3. The study findings showed that 46% (n=142) of the respondents had a good feedback on all the five (5) items under the perceptions of clinical teaching whereas 42% (n=142) of the respondents had a moderate view on all the five (5) items in the perceptions of clinical teaching sessions. With regards to the evaluation of clinical teaching sessions, 50% of the respondents had a moderate feedback on all the three (3) items in this section.

Conclusion: Most of the participants perceived and evaluated the clinical teaching as an important teaching-learning strategy in enhancing clinical learning.

Keywords: Perceptions, Evaluation, Nursing student, Clinical teaching, Nurses.

Citation: IeJSME 2016 10(2): 21-29

DOI: https://doi.org/10.56026/imu.10.2.21

Authors: Raja Noriza Raja Ariffin, Muzalwana Abdul Talib @ Abdul Mutalib, Nurulhuda Mohd Satar, Hanira Hanafi, Azmah Othman, Makmor Tumin, Rustam Khairi Zahari.

ABSTRACT

Background: There is a lack of information on the practice of family planning among Muslim women in New York City in the United States of America (USA) [hereinafter known as “Muslim women residing in the United States” (MWRIU)], Tehran in the Islamic Republic of Iran (IRI) and Kuala Lumpur, Malaysia. The limited figures on this issue are either outdated or mere estimates. The importance of sexual and reproductive health of Muslim women is expected to have massive effects on the social and economic progress of developing countries like the IRI and Malaysia. It is also expected to have imperative impacts on the attempts to empower the MWRIU community and enhance their health status to meet the national standards.

Objective: The study objective is to explore and compare the practice of family planning, namely on contraceptive use and abortion among Muslim women in 3 major cities of different countries.

Methodology: A survey of 379, 377 and 380 respondents from New York City, Tehran and Kuala Lumpur respectively was conducted in 2013 using self-administered questionnaires.

Results: There were significant differences in contraceptive and abortion practices across these countries (P<0.01). While a significant 86.6% of Iranian and 66.2% of the MWRIU used contraception, only 22.9% of the Malaysian women did so. For abortion, 13.6% of the MWRIU and 6.3% of the Malaysian respondents had abortion at least once; while only 22% of Iranians revealed their abortion history, totaling 32.1% of them who had abortion. Financial problems and having an unsupportive husband were among the major factors hindering their practice of healthy family planning.

Conclusion: Educational campaigns should be promoted to increase the awareness on the permissibility of family planning in Islam, as well as on sexual and reproductive rights.

Keywords: Barriers, comparison, contraception, family planning, Islam.

Citation: IeJSME 2016 10(2): 30-37

DOI: https://doi.org/10.56026/imu.10.2.30

Authors: Wei Fern Siew, Cindy Sze Nee Loh.

ABSTRACT

Background: Continuing professional development (CPD) is a primary strategy for nurses to keep abreast with the rapid changes in the health care practices of current times. Evidence has shown that nurses lack the initiative to take up the additional CPD offered by their organisation and have to be persuaded to do so once they have achieved the minimum 25 points of CPD mandated by Malaysia Professional Regulatory Board of Nursing (MNB).

Objective: To determine the extent to which nurses from a private hospital in Melaka will participate in CPD and the challenges affecting them from participating in CPD upon achieving the mandatory CPD points specified by MNB.

Methods: This is a cross-sectional descriptive survey. A sample of 188 registered nurses (RNs) from a private hospital in Melaka was recruited via purposive sampling technique to complete a self-reporting questionnaire. The instrument which was adapted and used with permission was pilot-tested for reliability and validated by content experts to ensure its suitability for this local study.

Results: The survey showed that 82.4% of the registered nurses (RNs) had attained additional CPD points apart from the minimum 25 CPD points stipulated by MNB. The findings on RNs reading journals or engaged in distance learning programmes were not encouraging as the percentages were only 31.4% and the latter, 9%. In-service talks, grand round discussions and online sources of continual nursing education that do not require the RNs to be away from their work duties were the most frequent type of CPD activities participated by the RNs as compared to conferences, workshops, distance learning programmes or post basic courses. The top 3 challenges that affect RNs’ participation in CPD were time constraint (90.4%), work commitments (85.6%) and difficulty in getting nominated (53.7%) to attend the CPD activities of their choice.

Conclusions: The results of this study highlighted the respondents’ views to the management on the importance to align the approach of sponsoring CPD courses according to the nurses’ needs in order to meet their context of practice. The management also ought to take into consideration the identified challenges encountered by the nurses to participate in CPD upon achieving their mandatory CPD points specified by MNB.

Keywords: Continuing professional education; nursing practice; professional development; registered nurses.

Citation: IeJSME 2016 10(3): 4-13

DOI: https://doi.org/10.56026/imu.10.3.4

Authors: Swee Geok Lim, Siew Woan Yam.

ABSTRACT

Introduction: Patient falls has been identified as one of the major issues in today’s health care despite efforts taken in preventing such incidents from happening (Cox et al., 2014). Patient falls can be prevented by using fall risk assessment tools such as Morse Fall Scale. Morse Fall Scale was implemented in the year 2014 in a private hospital in Malaysia but the patient fall rate did not decrease.

Objective: The research objective is to determine the nurses’ level of knowledge and competency in the use of the Morse Fall Scale as an assessment tool in the prevention of patient falls.

Method: A quantitative, descriptive, cross-sectional research design was conducted with 100 registered nurses from a private hospital in Selangor, Malaysia. Universal sampling technique was used to recruit the nurses.

Results: The registered nurses had a moderate level of knowledge (M = 7.72; SD = 1.72) and competency (scoring Morse Fall Scale, M = 4.75; SD = 1.26; planning intervention, M = 13.19; SD = 1.89) in using the Morse Fall Scale.

Conclusion: It is recommended that a review of the training programme on the use of the Morse Fall Scale be implemented in a more structured manner.

Keywords: Assessment tool, competency, patient falls, knowledge, Morse Fall scale.

Citation: IeJSME 2016 10(3): 14-23

DOI: https://doi.org/10.56026/imu.10.3.14

Authors: Tamara Gien Pooke, Rozi Mahmud, Poh Sin Yap, Suraini binti Mohamad Saini, Sharifah Roohi Syed Waseem Ahmad, Harwant Singh.

ABSTRACT

Introduction: The goal of this study was to assess the effectiveness of seated combined extension-compression and transverse load (ECTL) traction as a new method for increasing a reduced lordosis of less than 30 degrees in a Malaysian population between the ages of 18 and 60 years. Possible changes in disc height were measured in accordance with the underlying theoretical framework, that suggests the anterior cervical structures would elongate due to creep over the fulcrum of the traction device.

Method: This was a single centre, randomised, blinded controlled clinical trial with parallel groups, used to test the superiority of the seated combined ECTL traction together with physiotherapy exercises when compared with the same physiotherapy exercises used as a control. Fifty randomly allocated subjects who completed the forty treatments over the fourteen weeks were analysed using non-parametric tests for changes in outcomes.

Results: There were no significant changes in outcomes for disc height changes seen in this study. The findings of a greater overall increase in posterior disc height changes compared with anterior disc height changes were in contrast with the proposed underlying theoretical framework for this type of ECTL traction. The greater height changes occurring in the control group were also unexpected.

Conclusion: The findings in this study of the contrasting changes in disc height of greater posterior than anterior height changes, question the underlying theoretical framework as postulated for this type of traction.

Keywords: extension compression and transverse load traction, cervical lordosis, disc height.

Citation: IeJSME 2016 10(3): 24-33

DOI: https://doi.org/10.56026/imu.10.3.24

Authors: Makmor Tumin, Ahmad Farid Osman, Nurhidayah Abdullah, Sook Lu Yong.

ABSTRACT

Objectives: Health-related quality of life (HRQoL) is an essential dimension of overall human quality of life, in which disparities have been hypothesised between women and men, as well as between citizens and non-citizens of a country in past literatures. This study is to evaluate and compare the HRQoL of citizens and non-citizens living in greater Kuala Lumpur and Johor Bahru, as well as comparing HRQoL between genders.

Materials and Methods: The SF-8 questionnaire was used to collect information from 1,708 respondents (1,032 Malaysian citizens and 676 non-citizens), via face-to-face interview between October and December 2015.

Results: Overall, respondents reported moderate HRQoL. Non-citizens reported better HRQoL than the Malaysian citizens, while men reported better HRQoL compared to women (for both citizens and non-citizens).

Conclusions: The HRQoL of both citizens and non-citizens’ in Malaysia could be improved. Measures should be taken to remove the disparity in HRQoL between men and women, aiming to achieve equal health status for both genders.

Keywords: accessibility; gender; health; Malaysia; quality of life.

Citation: IeJSME 2017 11(2): 14-23

DOI: https://doi.org/10.56026/imu.11.2.14

Authors: Wai Mun Tang, Tze Yee Wong, Cherish Chai.

ABSTRACT

Background: Positive physician-nurse collaborative relationship is the key determinant for patients’ outcomes.

Objective: The purpose of the study was to investigate registered nurses’ attitude towards physician-nurse collaboration and its association with demographic characteristics.

Methodology: The study was descriptive and cross-sectional. The data of the study was collected using the “Jefferson Scale of Attitudes toward Physician-Nurse Collaboration”. The sample size of the study was 127 registered nurses recruited using convenience sampling. Descriptive statistics and inferential statistics t-test were used for data analysis.

Results: The results showed that nurses’ attitude towards physician-nurse collaboration was positive (M=3.25, SD±0.29). The attitude of the participants was highly positive towards “shares education and collaboration” (M=3.42, SD±0.36), “nurse’s autonomy” (M=3.42, SD±0.44), and “caring vs. curing” subscales (M=3.41, SD±0.41). However, the participants rated lowest for “physician’s authority” subscale (M=2.12, SD±0.83) and particularly on the item “doctors should be dominant authority in all health care matters” (M=2.11, SD±0.99). Furthermore, t-test analysis revealed no significant association between nurses’ attitude towards physician-nurse collaboration and demographic characteristics such as age, gender, and educational level (p > 0.05).

Conclusion: The results of the study provided some crucial evidences on nurses’ attitude towards physician-nurse collaboration. The evidences are useful for the relevant stakeholders to initiate relevant strategies to improve and strengthen the relationship gap between physicians and nurses.

Keywords: Attitude, physician-nurse, collaboration, registered nurses.

Citation: IeJSME 2017 11(1): 12-20

DOI: https://doi.org/10.56026/imu.11.1.12

Authors:  Swee Geok Lim, Chian Yi Low.

ABSTRACT

Introduction: Perioperative care is nursing care provided by perioperative nurses to surgical patients during the perioperative period. Its role is important as patients especially those who had undergone coronary artery bypass graft (CABG) surgery encounter high levels of psychological and physical stress.

Objective: To determine the needs of CABG patients throughout the perioperative period and how well those needs were met.

Methods: This is a cross sectional descriptive survey. A total of 88 patients who had undergone coronary artery bypass graft were recruited through census sampling. The instrument which was adapted and used with permission for this study was “Survey of Patient Needs and Experiences during the Perioperative Period’ questionnaire (Davis et al., 2014).

Results: The patients perceived the perioperative needs in the post-anaesthesia care unit area to be the most important (M = 2.89, SD = 0.06). Perioperative needs which were rated the highest for each of the four time periods were “Having information about the surgical procedure itself”, “Having your family member or significant other with you in the pre-surgical area complications”, “Being treated with respect and with dignity by hospital personnel” and “Having your family member or significant other visit you in the recovery room”. Overall, patients perceived their needs during perioperative period to be partly met (M = 2.73, SD = 0.07) with post-anaesthesia care unit area being rated the highest (M = 2.81, SD = 0.06).

Conclusion: The results of this study highlighted the perceived needs of patients undergoing coronary artery bypass graft surgery throughout their perioperative period. In order to improve the quality of perioperative care for patients, nurses need to take into consideration the important needs identified by the patients and address the items which were not meeting the needs of the patients.

Keywords: Coronary artery bypass graft, Intra-operative care, Operating theatre, Perioperative care, Pre-operative care, Post-anaesthesia care.

Citation: IeJSME 2017 11(1): 21-32

DOI: https://doi.org/10.56026/imu.11.1.21

Authors: Thiruselvi Subramaniam, Ann Jee Tan.

ABSTRACT

Background: House-officers and medical officers are at the forefront during medical emergencies in the ward and casualty which impose cognitive, communication, social and system challenges and yet, training in this area is commonly lacking. A workshop was conducted using simulation to provide training on some acute medical emergencies like cord prolapse, post- partum haemorrhage with collapse, poly-trauma and acute exacerbation of asthma.

Objective: To determine the effectiveness of simulation in developing competency in managing selected clinical emergencies

Methodology: There were 22 participants consisting of house-officers, junior medical officers and nursing clinical instructors. Only doctors were included in the study. Four medical emergencies were chosen viz.: Cord prolapse; post-partum haemorrhage with collapse; poly-trauma and acute exacerbation of asthma. The simulated sessions were conducted using high fidelity manikins and simulated patients. Simulated patients were trained and moulage was applied accordingly. The skills stations were on airway equipment and techniques of application, latest cardiac life support algorithm and hands on chest compression using manikins.

Results: A 5 point Likert scale used to rate the sessions. The skills station had 65% (n=13) rating as excellent and 35% (n=7) good. The skills simulation was rated excellent by 75% (n=15) and good by 25% (n=5) of participants. Verbal feedback was that it was very refreshing, informative, and helpful in terms of improving their skills.

Conclusion: The simulated skills training for the junior doctors was very well received and maybe beneficial for work preparedness and in the long run address patient safety.

Keywords: Junior doctors, medical emergencies, medical curriculum, resuscitation, simulation, work-preparedness.

Citation: IeJSME 2017 11(1): 33-38

DOI: https://doi.org/10.56026/imu.11.1.33

Authors: Zher Lin Go, Hon Shen P’ng, Wai Seng Cheong.

ABSTRACT

Background: While international data exists on hospitalisation and its associated mortality among endstage renal disease (ESRD) population on maintenance renal replacement therapy (RRT), local data is not known. The objective of this single centre retrospective observational study is to determine the burden of hospital admission and readmission among the ESRD population and the mortality outcome after hospitalisation.

Methods: We obtained our study data from the HSNI Batu Pahat nephrology service inpatient database, patients’ medical records and Jabatan Pendaftaran Negara (JPN) registry of death.

Results: There were 195 index admissions identified from January to June 2016. We found that hospital readmission rate was high at 19.5% within 30 days, 34.4% within 60 days, and 44.6% within 90 days of discharge. Commonest reason of admission was fluid overload (20.7%). Overload was also the commonest reason of readmissions within 30 and 60 days (28.9% and 23.8% respectively), whereas vascular access related issues were the commonest reason of readmission within 90 days of discharge (21.8%). The 90-day mortality rate after index admission was also high at around 18%. The commonest cause of mortality was Infection and Sepsis (42.9%), followed by Acute Coronary Syndrome (22.9%).

Conclusions: This study demonstrated the heavy burden of hospitalisation and high mortality rate among ESRD populations. Further larger researches are welcomed to look into the factors associated and the problems faced, in order to improve not only individual morbidity and mortality outcomes, but also on hospitalisation cost and healthcare resources.

Keywords: ESRD on RRT, Hospital Admission, Readmission, Mortality after Hospital Admissions, Reasons of Admission, Reasons of Readmission, Reasons of Mortality.

Citation: IeJSME 2018 12(3): 12-20

DOI: https://doi.org/10.56026/imu.12.3.12