The organizational implications of medical imaging in the context of Malaysian hospitals

This research investigated the implementation and use of medical imaging in the context of Malaysian hospitals. In this report medical imaging refers to PACS, RIS/HIS and imaging modalities which are linked through a computer network. The study examined how the internal context of a hospital and its external context together influenced the implementation of medical imaging, and how this in turn shaped organizational roles and relationships within the hospital itself. It further investigated how the implementation of the technology in one hospital affected its implementation in another hospital. The research used systems theory as the theoretical framework for the study. Methodologically, the study used a case-based approach and multiple methods to obtain data. The case studies included two hospital-based radiology departments in Malaysia. The outcomes of the research suggest that the implementation of medical imaging in community hospitals is shaped by the external context particularly the role played by the Ministry of Health. Furthermore, influences from both the internal and external contexts have a substantial impact on the process of implementing medical imaging and the extent of the benefits that the organization can gain. In the context of roles and social relationships, the findings revealed that the routine use of medical imaging has substantially affected radiographers’ roles, and the social relationships between non clinical personnel and clinicians. This study found no change in the relationship between radiographers and radiologists. Finally, the approaches to implementation taken in the hospitals studied were found to influence those taken by other hospitals. Overall, this study makes three important contributions. Firstly, it extends Barley’s (1986, 1990) research by explicitly demonstrating that the organization’s internal and external contexts together shape the implementation and use of technology, that the processes of implementing and using technology impact upon roles, relationships and networks and that a role-based approach alone is inadequate to examine the outcomes of deploying an advanced technology. Secondly, this study contends that scalability of technology in the context of developing countries is not necessarily linear. Finally, this study offers practical contributions that can benefit healthcare organizations in Malaysia

Evaluation Of Air-Conditioning And Mechanical Ventilation (Acmv) Performance In Ambulatory Care Centre (Acc) Hospital Pulau Pinang

Prestasi ACMV untuk kemudahan giat tenaga seperti ACC sangat bergantung kepada operasi EMCS. ACMV performance for energy demanding facilities such as ACC is heavily dependent on EMCS operation

The Development and Testing of Consensus Recommendations for Collaborative Practice in the Malaysian Mental Health System

This project used participatory action research to develop and test a model of collaborative practice for the Malaysian mental health system. A hospital committee and a Delphi committee were formed to create a set of collaborative practice guidelines. Some of these recommendations were implemented in a psychiatric hospital, including staff training and systems changes. A realist evaluation, using both qualitative and quantitative methods, showed that some of these changes were effective in improving collaboration

Recognizing early warning signs (EWS) in patients is critically important

Introduction: Monitoring vital signs is a basic indicator of a patient’s health status and allows prompt detection of delayed recovery or adverse effects and early intervention. Patients with adverse events during hospitalization often display clinical decline for several hours before the event is observed. Non-critical care Nurses’ inconsistent recognition and response to patient deterioration lead to an increase in the length of hospital stay, unexpected admissions to the ICU, and increased morbidity and mortality. Aim: The study aimed to assess the factors that facilitate or impede the detection of early warning signs among adult patients hospitalized in tertiary care settings. Training should be provided to improve nurses’ knowledge, practice and attitude toward early warning signs of deteriorating patients leading to enhanced clinical judgment, skills and decision-making in addressing alerts. Methodology: A literature search was carried out in various databases; these were Cumulative Index to Nursing and Allied Health Literature (CINHAL), Google Scholar, PubMed, Science Direct, and Sage. The search area was narrowed from 2017 to 2022. The keywords used were “prevalence” AND “unplanned ICU admission”, “the importance of early warning signs” “outcome failure in rescue” “patient deterioration, communication” “improvement in early detection” AND “patient outcome admission” AND “early warning signs” AND “Pakistan”. After the analysis process, around 33 articles that met the inclusion criteria and were most relevant to the scope and context of the current study were considered. Conclusion: Most of the studies had reviewed literature in a qualitative retrospective observational study, content analysis, mixed method, and quasi-experimental study. The literature review identified that long hours of shift, nurse staffing levels, missed vital signs, lack of nursing training and education, and communication impact nurses’ ability to recognize and respond to early warning signs

Prevalence and factor associating medication error among registered nurses at Public Hospital Ipoh

Medication administration is an important task performed daily by nurses and is one of the key aspects of safe patient care. Research indicates that when medication errors occur the concern is usually for the patients involved in the incident. However, making a medication administration error has a lasting effect on the nurse as well as the patient (Schelbred & Nord, 2007; Treiber & Jones, 2010). The objective of the study is to evaluate the prevalence and factor associate medication error among registered nurse at public hospital Ipoh. Method of the study is quantitative study in carry out the research from the questionnaires. This study has conducted two types of statistics namely descriptive and inferential. Data collected from N = 80 respondents from two clinical areas; medical and surgical ward. The data collected through this questionnaire was analysed with the help of statistical program for social science (SPSS) version 24.0. The data were statistically treated using mean, standard deviation and one-way ANOVA test. Based on the key findings of the study, it found out the element related to 'preparing and administering' (mean=4.88) was the highest prevalence compared to other elements. This study also found that management factor (mean = 3.55; SD = 4.914) was the main factor contributing to the incident of medication error at the study location followed by environmental factor (mean = 3.53; SD = 4.231) and human characteristic factor with mean score = 3.51 (SD = 4.237). While one-way ANOVA test showed that the difference in marital status of the respondents was significant with the causative factor of medication error with the value is (p=0.027). In conclusion, this review paper summarizes the preventive measures of medication errors made by nurses. As it is obvious, there is a plenty of factors that need to be applied in the hospital to succeed low medication error rate. To improve nurses‘ knowledge of how individual factors, contribute to errors and help them develop effective strategies to prevent errors occurring, it is important that institutions reward and encourage leaders who demonstrate characteristics of mindfulness on all levels. (Abstract by author

Hospital design in tropical Malaysia - towards a green agenda

‘Sustainability’ as a terminology, is a broad concept and a requirement in building designs with a tendency of being abuse through trendy and over commercialisation. In the arena of hospital design, new is usually associated to being modern and therefore, green. In the quest of getting to know the “tree” from “the forest” from among the hundreds of existing hospitals, ranged from colonial, early independence to the new hospital designs, a yardstick, to measure those that is actually “green” and “sustainable” need to be set. This study intends to provide a qualitative definition and provide recommended criteria of a green hospital designs in the context of tropical climate of Malaysia and its people. A qualitative method of approach through case studies of hospital designs from pre-colonial to the present were made. Aspects studied include the physical architecture that significantly affect health i.e. the building configuration, form, space quality, material use and culture. Findings indicated that there is a variety of degree and factors to the implementation of the green qualities in all the designs. The range includes intuitive and regulatory approach to green considerations in the design. Conditions of the site, cost, construction time, planning time, expertise, experience and procurement methods are among the constraints where compromises had to be made as a priority. Significance of the findings will contribute to the qualitative criteria for healthcare building Green requirement especially for tropical climate of Malaysia

The role of organizational and professional cultures in medication safety: a scoping review of the literature

Purpose: This scoping review explores what is known about the role of organizational and professional cultures in medication safety. The aim is to increase our understanding of ‘cultures’ within medication safety and provide an evidence base to shape governance arrangements. / Data sources: Databases searched are ASSIA, CINAHL, EMBASE, HMIC, IPA, MEDLINE, PsycINFO and SCOPUS. / Study selection: Inclusion criteria were original research and grey literature articles written in English and reporting the role of culture in medication safety on either organizational or professional levels, with a focus on nursing, medical and pharmacy professions. Articles were excluded if they did not conceptualize what was meant by ‘culture’ or its impact was not discussed. / Data extraction: Data were extracted for the following characteristics: author(s), title, location, methods, medication safety focus, professional group and role of culture in medication safety. / Results of data synthesis: A total of 1272 citations were reviewed, of which, 42 full-text articles were included in the synthesis. Four key themes were identified which influenced medication safety: professional identity, fear of litigation and punishment, hierarchy and pressure to conform to established culture. At times, the term ‘culture’ was used in a non-specific and arbitrary way, for example, as a metaphor for improving medication safety, but with little focus on what this meant in practice. / Conclusions: Organizational and professional cultures influence aspects of medication safety. Understanding the role these cultures play can help shape both local governance arrangements and the development of interventions which take into account the impact of these aspects of culture