INTERNATIONAL JOURNAL OF CARE SCHOLARS

The Art of Nursing: Time to Resuscitate

Sumaiyah @ Thandar Soe Jamaludin — 2023-07-31

Knowledge, Attitude, and Practice of Antibiotic Use and Resistance among Medical and Sciences Students of International Islamic University Malaysia.

Mohd Hanif Jainlabdin — 2023-07-31

Introduction: Antibiotic resistance is a significant public health concern that can affect both human and environmental health. The use of antibiotics in agriculture can contribute to the development of antibiotic-resistant bacteria, which can spread to humans through contaminated food or water. Educating the public on antibiotic resistance threats is crucial, and this can be achieved through well-informed medical and science students using practical and simple terms. Objective: The objective of this study is to assess the level of knowledge, attitude, and practice of antibiotic use among medical and sciences students of International Islamic University Malaysia. Methodology: The study was cross-sectional, and the study instrument was developed through an extensive literature search and validated by medical and science students. A pilot study was conducted to determine reliability, and data was analyzed using SPSS version 26 with descriptive and inferential statistics. Results: The study included 312 respondents, with 154 (49.2%) from the Faculty of Medicine and 159 (50.8%) from the Faculty of Science. The majority of respondents had adequate knowledge related to antibiotics. Age and faculty were associated with knowledge level, while faculty and attendance at training and workshops were associated with practice level. There were no significant associations between demographic variables (such as gender and nationality) and knowledge, attitude, and practice levels among medical and science students, except for faculty of participants. Conclusion: The students demonstrated a good understanding of antibiotic resistance, with medical students showing slightly better knowledge than science students. The study suggests conducting future studies with an interventional design to improve medical students' knowledge and attitudes towards antibiotic use and resistance.

The Impact of Tracheostomy Timing (Early and Late) on Severe Head Injury Patients Toward Clinical Outcomes

Muhammad Farhan Mahmud — 2023-07-31

Introduction: Severe head injury patients require a specific treatment plan and nursing care to achieve an optimal clinical outcome. Mild head injury patients may need a few days of hospitalisation for close monitoring and conservative medical administrations. However, in severe head injury cases, the patients may require a more extended period of hospitalisation for a series of complex neuro-medical and neurosurgical management. Tracheostomy may be performed on head injury patients with protracted breathing problems. Early tracheostomy (ET) may improve clinical outcomes late tracheostomy. ET is defined as the tracheostomy done seven days after the initiation of endotracheal intubation. Objective : The objective of this study is to determine the impact of ET on a patient's clinical outcome before being discharged. Methodology: This is a retrospective cohort study involving 45 severe head injury patients with tracheostomy done in two Neuro-Centre hospitals in Klang Valley. The clinical outcome was observed before the participants are discharged including the participant's GCS upon discharge, length of stay (LOS) in the ICU and hospital, the incidence of VAP, duration of mechanical ventilation dependency, and decannulation rate. Findings: There are 45 participants in this study as the sample. Crude analysis performed in this study showed that there is a significant association between tracheostomy classification (early and late) toward participant length of stay in the ICU with a p-value of <0.001, LOS in the hospital (p=0.002), and duration on the mechanical ventilation use (p<0.001) with no association with the GCS upon discharge (p=0.057), the incidence of VAP (p=0.374), and decannulation rate (p=0.081).Potential confounding factors in this study were determined statistically. It was done by comparing the model without an additional factor and the model with an additional factor. Multivariate analysis showed that the association between these variables remained significant for the LOS in the hospital (p=0.035) and duration of mechanical ventilation used (p=0.005). Conclusion: The initiation of ET contributes to a favourable clinical outcome in terms of the duration of mechanical ventilation and length of hospital stay for patients with a severe head injury. However, the association between tracheostomy categorisation and ICU LOS, incidence of pneumonia, decannulation rate, and GCS at discharge was not statistically significant.

A Critical Reflection on Integrating Gardening Activities into Psychiatric Patient Care from The Nurses' Perspectives

Abdul Hadi Zulhiqman Abdul Rahim — 2023-07-31

Background: Gardening has multiple physical and mental health tangible benefits. However, gardening has never been fully implemented in healthcare settings where patient care is prioritized. Objective: This study aimed to explore how mental health nurses in Brunei perceive gardening activities as part of their patient care. Methods: In this descriptive qualitative study, thematic analysis of four focus group discussions (n= 22 nurses) in one psychiatric department in Brunei Darussalam was identified through purposive sampling. Findings: Three overarching themes arose from the analysis (1) Safety during gardening, (2) Maintaining the interest, (3) Coordinating the activity. Conclusion: The nurses in this study highlighted the significant benefits of gardening for patients, but they still consider that consultation and medication are the most critical aspects of patient care. However, gardening can still be interwoven into patient care as a complementary therapy offered to patients as part of their discharge plan and recovery process.

Clinical Handover Practice in the Emergency and Trauma Department of SASMEC@IIUM: An Observational Qualitative Study.

Nurul'Ain Ahayalimudin — 2023-07-31

Introduction: Clinical handover is a critical nature of communication between the staff, given it physicians, nurses or even the assistant medical officer. Specifically, in Emergency and Trauma Department(ETD) where turnover of patients is high in a fast-paced environment with unpredictable events, the tendency of communication failure and errors increased. In ensuring safety and efficient clinical handover practice, demands critical information that needed to be informed when communicate between the shifts or the staff. Therefore, this study mainly to identify the best way of clinical handover that would assist in better communication amongst emergency healthcare providers as well as within different departments. Objective: To examine the current shift handover practices amongst emergency staff at SASMEC@IIUM, identify the resources and supports to enhance clinical handover effectiveness and to determine the barriers and facilitators on the effectiveness of clinical handover. Methodology and Methods: A descriptive, qualitative study was conducted by selecting samples through purposive sampling technique. Nurses, physicians and assistant medical officers were selected in this study. The sample size was determined using the ‘saturation criterion’. Topic guide interview has been selected for the participants to share their opinions, suggestions, and experiences. Open-ended questions have been used to identify the participants’ perspectives towards the current practices of clinical handover in Emergency and Trauma Department of SASMEC. Data were then analysed using thematic analysis and later developed into sub-themes and themes. Findings: Six themes were identified for this study which consist of 1) learning methods of clinical handover, 2) information passed to next shift, 3) information expected to receive, 4) opinions on current handover, 5) handover effectiveness 6) suggestions for improvement. The themes described mostly on the experiences, opinions and suggestions from the healthcare professionals working in the Emergency and Trauma Department of SASMEC. Conclusion: This study found that the healthcare providers in ETD have various backgrounds of learning clinical handover, with some of them have different working experiences since they worked in other hospitals, departments, or settings previously. In addition, they also described their own experiences in handling clinical handover in ETD SASMEC, together with the factors that affect the effectiveness of the clinical handover process. Besides, the findings were also concentrated on the elements that the participants assumed may be beneficial for the improvement of clinical handover overall that could be done in future.

Keywords: Clinical handover, Practice, Emergency Department, Qualitative, Malaysia

Exploring COVID-19 Vaccines Hesitancy Among The Muslim Community of The East Coast Region in Malaysia

Mohamad Firdaus Mohamad Ismail — 2023-07-31

Introduction: The development of vaccines against SARS-COV-2 infections has marked a significant milestone in the current COVID-19 pandemic. The COVID-19 vaccines can provide a way to prevent the pandemic. Despite the high acceptance rate, Pahang, Terengganu, and Kelantan (east coast region) remain the lowest vaccination rate in Malaysia. Most of Malaysia's population in the east coast region is Muslim, but there is no study exploring this phenomenon. Objective: This study aims to understand the COVID-19 vaccine hesitancy among Malaysia's Muslim community of the east coast region. Methodology: This study used a qualitative research design study. Six participants from the east coast region of Malaysia were recruited from February until June 2022. The recruitment techniques used purposive sampling methods. In-depth interviews with participants were used on virtual platforms. Data were analyzed using thematic analysis. Findings: Three themes were identified 1) source of information; they believe rumours spread by the anti-vaccine movement or their close family 2) safety issues concern; they are scared of potential side effects of the COVID-19 vaccine, 3) self-belief; they believe self-isolation and proper diet better than vaccine intervention. Conclusion: Although 95.7 per cent of the population is wholly vaccinated, some still do not intend to take any COVID-19 vaccination in Malaysia. This study can provide data and crucial information that will help develop strategies to remove the related hesitancy and improve public uptake of the COVID-19 vaccination.

Nurses' Understanding of Ethical Dimension of Using Electronic Health Records (EHRs)

Nurisbaniah Hj Ismail — 2023-07-31

Background: Electronic Health Records (EHRs) undoubtedly offer various advantages over the paperwork system. However, the utilisation of EHRs has been questioned, particularly among nurses, who are the leading users of EHRs among other healthcare professions. Objective: This study aimed to explore the nurses' understanding of ethical concerns with using EHRs. Methods: A qualitative descriptive study design was applied in this study. Purposive sampling was employed to recruit ten nurses, which proved sufficient to achieve data saturation. Semi-structured individual via phone interviews and face to face was conducted in August 2021 and audio recorded. A qualitative thematic analysis approach was utilised. Findings: Three overarching themes arose from the analysis: (1) Access to patient information, (2) Disclosure of patient information, (3) Maintaining ethical integrity. Conclusions: The research showed that nurses knew the ethical considerations surrounding patient information access and disclosure. However, concerns were raised about inappropriate access and sharing of personal EHR accounts and passwords. Additionally, the nurses felt that an ethical code alone would not discourage nurses from inappropriately using EHRs. Consequently, it highlights the need to revise the current ethical codes to include measures to maintain health data integrity.

Ethical Responsibilities in Patient Education

Yusrita Zolkefli — 2023-07-31

Planetary Health and Nursing: A Call to Action for a Sustainable Future

Mohd Hanif Jainlabdin — 2023-07-31

Revisiting Nurse Scheduling Practice

Yusrita Zolkefli — 2023-07-31