Issue: IeJSME 2018 12(2)

Patient’s level of satisfaction with nurse-led telephone follow-up after cataract surgery at a private eye specialist centre in Penang

Authors: Swee Geok Lim, Aun Cyi Lim, Xiao Jing Wong.

ABSTRACT

Introduction: The prevalence of cataract surgeries ranges from 7 to 12 million cases in 2000, 20 million in 2010 and an estimation of 32 million cataract surgeries annually by the year 2020 worldwide (WHO, 2015). Traditionally, the healthcare providers were only able to give health education before the patient is discharged from the healthcare setting while follow-up can only be done when the patient comes for their follow-up. But most of the patients will remain confused or had forgotten about the post-operative care even after receiving a comprehensive discharge preparation. However, with the advancement of technologies in this modern era, nurse-led telephone follow-up can be considered as a tool to assist healthcare providers in the follow-up care in Malaysia. On the same note, a private
eye specialist organisation with centres throughout Malaysia, had taken the initiative to provide telephone follow-up service for their patients with three main objectives namely, to provide pre- and post-education on cataract surgery, to detect early post cataract surgery complications as well as to minimise anxiety among their patients. However, till date no patient feedback regarding the service was conducted.

Objective: The research objective for this study was to determine patient’s level of satisfaction with the nurse-led telephone follow-up after cataract surgery at a private eye specialist centre in Penang.

Method: A cross sectional quantitative descriptive study design was used to study ninety post cataract patients in a private hospital, Penang through universal sampling method. A validated self-developed questionnaire based on the three main objectives of the telephone follow-up service was used for this study.

Results: Overall, the level of patient’s satisfaction with nurse-led telephone follow-up after cataract surgery at a private eye specialist centre in Penang was high (49.9±4.85) especially for the health education provided (4.18 ±0.21) followed by the effort to detect early complications (4.16 ±0.12) and to minimise patients’ anxiety level (4.16 ±0.12).

Keywords: cataract surgery, level of satisfaction, nurse-led telephone follow-up, patient.

Citation: IeJSME 2018 12(2): 4-13

DOI: https://doi.org/10.56026/imu.12.2.4

Nurses’ perceptions of self-efficacy in cardiopulmonary resuscitation at a private hospital in Selangor

Authors: Siew Eng Ho and Sok Ching Tee.

ABSTRACT

Introduction: Nurses are obligated to respond competently in the event of cardiac arrest. Nurses could be hesitant to intervene due to low self-efficacy in their ability to manage cardiac arrest patients.

Objective: The objective of this study was to determine the level of nurses’ perceived self-efficacy in cardiopulmonary resuscitation (CPR) at a private hospital in Kuala Lumpur.

Method: A cross-sectional descriptive study was conducted with 112 respondents who fulfilled the inclusion criteria. A 19 item questionnaire on Resuscitation Self-Efficacy Scale (RSES) was adapted and scored using a 5-point Likert scale.

Results: The total mean score and standard deviation of perceived self-efficacy score in resuscitation was (M = 77.68; SD ± 11.77) which indicated a high degree of self-efficacy among nurses. There were significant differences between respondents’ age groups with (t = -2.520; p = 0.013), unit of working (t = -4.086; p = 0.001), real experiences in resuscitation (t = 2.532; p = 0.013), and the number of participations in resuscitation (t=-6.668; p=0.001) and nurses perceived self-efficacy in CPR. There were also significant differences between respondents’ years of working experience with (F = 7.286; p =0.001) and types of last resuscitation training (F= 7.088; p = 0.001). However, there was no significant difference between the nurses’ time of their last resuscitation training (F = 1.225; p = 0.298) and the nurses perceived self-efficacy in CPR.

Conclusion: In conclusion, nurses were deemed to possess a high sense of self-efficacy in CPR. This study concluded that nurses’ age groups, years of working experience, unit of working, real experiences in resuscitation and the number of participations in resuscitation and types of last resuscitation training are factors contributing towards self-efficacy in CPR performances. However, the time of last resuscitation training reported no significant difference towards nurses’ perceived self-efficacy in CPR. Therefore, repetitive CPR and ACLS certification training are pivotal in order to strengthen nurse’s self-efficacy in resuscitation and team collaboration through training in this private hospital.

Keywords: Nurses, perception, self-efficacy, cardiopulmonary resuscitation.

Citation: IeJSME 2018 12(2): 14-21

DOI: https://doi.org/10.56026/imu.12.2.14

A palatal swelling transpires out as a nasal B-cell Non-Hodgkin’s Lymphoma

Authors: Sunil Pazhayanur Venkateswaran, Rafiq Abdul Karim Vasiwala, Norfadzilah Mohd Yusof.

ABSTRACT

Primary sinonasal Non-Hodgkin’s Lymphoma’s (NHLs) are quite rare and emulate the presentation of benign inflammatory diseases. It is challenging to distinguish them morphologically and radiologically from other malignant neoplasms. We report a 37-year-old male patient who presented with obstruction of the nasal passages, rhinorrhoea, epistaxis, post nasal drip, facial swelling, orbital symptoms and pyrexia. The mass was a nasal diffuse large B-cell lymphoma confirmed by immunohistochemistry. After the first cycle of chemotherapy was started, the patient improved with resolution of the facial swelling, pain and visual defects. A high index of suspicion is required to differentiate sinonasal lymphomas from other lesions.

Keywords: Diffuse large B-cell lymphoma, palate, CD20, CD79α, and KI-67.

Citation: IeJSME 2018 12(2): 22-25

DOI: https://doi.org/10.56026/imu.12.2.22

Femoral deformity correction and lengthening on nail with monorail external fixator : A case report

Authors: Mohd Bakrynizam Abu Bakar Siddiq, Kamarul Izham Kamarudin, Kamarul Al Haq, Suresh Chopr.

ABSTRACT

Limb length discrepancy (LLD) is quite common. Lower limb shortening is one of the causes of limb length discrepancy. The common treatment that is used is the llizarov technique for bone lengthening. The new technique uses an intramedullary nail with a monoplanar external fixator. Using this technique, bone lengthening duration in patients can be reduced and knee joint mobility can be improved without jeopardizing bone regeneration. We report a case of a 27-year-old gentleman who had right femur shortening from childhood and was referred to us for corrective deformity. He underwent bone lengthening on the nail which lenghthens and equalizes the leg while avoiding stiffness and reduces joint mobility which leads to good patient satisfaction outcome. The use of the external fixator with intramedullary nailing to lengthen the femur is one method that can reduce patient burden mentally and physically. However although it has many advantages we must watch out for the complications during the regular visits to ensure good outcome.

Keywords: Bone lengthening, limb length discrepancy, external fixator.

Citation: IeJSME 2018 12(2): 26-29

DOI: https://doi.org/10.56026/imu.12.2.26

Surgical management of a mangled foot by a free vascularized fibular graft: A case report

Authors: Ren Yi Kow, Akmal Azim Ahmad Alwi, Aziah Abdul Aziz, Muhammad Firdaus Abas, Chooi Leng Low.

ABSTRACT

The human foot serves as an important part to support the body weight and accounts for the majority of our movements. A mangled limb involves injury to at least three out of four systems, namely the soft tissues, nerves, blood supply and bone. While amputation is indicated in some cases of mangled limb, with proper planning, limb salvaging surgical management is also a viable option. Special consideration to the skeletal stabilization, control
of infection, vascular status and soft tissue coverage is paramount to the success of limb salvaging surgery. We present a case of mangled limb which was successfully treated with limb salvaging surgical management. Initial debridement, Kirschner wires insertion and cross ankle external fixation were used for skeletal stabilization. An antibiotic spacer was inserted for local antibiotic and to maintain the length left due to the loss of medial and intermediate cuneiform bones. The anterior tibialis artery and its venae comitantes were utilized for free vascularized fibular graft to provide bony reconstruction as well as soft tissue coverage for the mangled foot.

Citation: IeJSME 2018 12(2): 30-33

DOI: https://doi.org/10.56026/imu.12.2.30

Bone transport using semicircular Ilizarov ring fixator in the treatment of the infected nonunion of the humerus: A case report

Authors: Kamarul Izham bin Kamarudin, Jun Wei Then, Ching Wooi Yeoh, Ying Jing Ooi, Chopra S.

ABSTRACT

Bone transport using the Ilizarov technique has been one of the most popular techniques in treating fracture with significant bone defect. However, pain and joint stiffness following Ilizarov fixation are few of the well-known complications. We report a case of a 23-year-old gentleman with a closed left humeral diaphyseal fracture following a traffic accident who underwent plating of the left humerus which was later complicated with infected nonunion. He was then treated with corticotomy and bone lengthening using the semicircular Ilizarov ring fixator. Good clinical and functional outcomes were observed during transportation period (elbow flexion 10̊ to 90̊) with minimal complications.

Keywords: Semi-circular Ilizarov rings, infected nonunion, bone transport.

Citation: IeJSME 2018 12(2): 34-36

DOI: https://doi.org/10.56026/imu.12.2.34