The Institutionalization and Processual Elements of Operational Risk Management as a Best Practice in a Government-Linked Organization: A Case Study in Malaysia

Operational risk management practice varies from one organization to another. There is no consistency in its implementation. This has caused misinterpretation, half-hearted implementation which eventually, denies the full function of its capabilities to support a business operation. Previous studies have provided limited exposure in finding on the best practice of operational risk management implementation. To fill the gap, this study aimed to uncover and explore how operational risk management is institutionalized within an organization and the best practice from a primary GLC in Malaysia. An extended case study approach by Burawoy (1998) was adopted. The primary data from 42 semi-structured interviews were analyzed using thematic analysis. The study found seven processual stages which the case company underwent to institutionalize risk management and regarded as the best practice of operational risk management implementation that supports business operations. Namely, strong leadership and obtaining external consultancy, setting the apparatus and assignment of tasks to the person in charge, risk framework, risk diagnostics, monitor and measure, developing and nurture a risk management culture, and consistent risk management enforcement and monitoring. These are regarded as a best practice by similar organizations in its secto

Pattern of herbal and dietary supplement usage and conventional medication adherence among patients with chronic kidney disease: a survey finding

Introduction: There is widespread use of herbal and dietary supplements worldwide among patients despite robust clinical evidence of its efficacy. This may lead to adverse effects, such as diabetes,hypertension, stroke, cardiovascular risk and kidney problems due to inappropriate self-prescription. This study was performed to determine the prevalence of herbal and dietary supplements usage among patients with chronic kidney disease and its association with the socio-demographic background and the conventional medication adherence. Materials and methods: A survey was conducted among 78 chronic kidney disease patients attending the Nephrology Clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Data were collected using a questionnaire and analyzed using descriptive statistics, Chi Square Test and Fisher’s Exact Test. The p-value was set to be less 0.05 for its level of significance. Results: Most of the patients aged more than 50 years (89.7%), female (53.8%), unemployed (41%) and from lower socioeconomic earners (75.6%). Only 5.2% of respondents reported using herbal and dietary supplements. There was no association between socio-demographic background with the herbal and dietary supplements usage. Similarly, there was no association between herbal and dietary supplements usage and the conventional medication adherence. Conclusion: This study provides a good baseline on the usage of herbal and dietary supplements use among chronic disease patients. It can be concluded that the level of awareness among the patients is good. Nevertheless, a larger study shall be performed in the future to explore the pattern of association

Malnutrition risk among chronic kidney disease patients attending the nephrology clinic in Hospital Tengku Ampuan Afzan, Pahang

Objective: The prevalence of chronic kidney disease among adult in Malaysia has been increasing and it is forecasted that the pattern will remain. The risk for malnutrition is prominent especially in the later stage of chronic kidney disease. Early detection of malnutrition is important to prevent further complications. However, limited studies on malnutrition risk has been conducted in Malaysia. Therefore, this study was performed to determine the prevalence and associated risk factor of malnutrition among chronic kidney disease patient attending Nephrology Clinic in Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Methods: A cross-sectional study was conducted among 70 chronic kidney disease patients using convenience sampling. All patients were explained about the study and informed consent obtained prior the administration of questionnaire. There were three parts of questionnaire to be answered which were on sociodemographic, clinical characteristic and dietary information along with Malnutrition Risk Screening Tool-Hospital to measure the risk for malnutrition. Results: Most of the participants were married (75.7%), had completed primary school (58.6%), currently not working (32.9%), had income between RM 1000 to RM 1999 (37.1%) and living with three or four members in a household (24.3%). Majority had at least one precipitating disease that causes chronic kidney disease such as hypertension (71.4%) followed by diabetes (61.4%) and high cholesterol (30.0%). Almost 21.4% of chronic kidney disease patients screened were at risk for malnutrition. Further inferential analysis shows an association between weight loss (p=0.001) towards risk for malnutrition. Conclusion: Overall, the risk for malnutrition among chronic kidney disease patient was fairly high. This warrant close attention of the healthcare professional that caring for the patients particularly in detection of detrimental weight loss during each follow up visit. A referral to the dietician is important to ensure the patients received adequate counselling and education on dietary management