Does good critical thinking equal effective decision-making among critical care nurses? A cross-sectional survey

Background A critical thinker may not necessarily be a good decision-maker, but critical care nurses are expected to utilise outstanding critical thinking skills in making complex clinical judgements. Studies have shown that critical care nurses’ decisions focus mainly on doing rather than reflecting. To date, the link between critical care nurses’ critical thinking and decision-making have not been examined closely in Malaysia. Aim To understand whether critical care nurses’ critical thinking disposition affects their clinical decision-making skills. Method This was a cross-sectional study in which Malay and English translations of the Short Form-Critical Thinking Disposition Inventory-Chinese Version (SF-CTDI-CV) and the Clinical Decision-making Nursing Scale (CDMNS) were used to collect data from 113 nurses working in seven critical care units of a tertiary hospital on the east coast of Malaysia. Participants were recruited through purposive sampling in October 2015. Results Critical care nurses perceived both their critical thinking disposition and decision-making skills to be high, with a total score of 71.5 and a mean of 48.55 for the SF-CTDI-CV, and a total score of 161 and a mean of 119.77 for the CDMNS. One-way ANOVA test results showed that while age, gender, ethnicity, education level and working experience factors significantly impacted critical thinking (p < 0.05), only age and working experience significantly impacted clinical decision-making (p < 0.05). Pearson’s correlation analysis showed a strong and positive relationship between critical care nurses’ critical thinking and clinical decision-making (r = 0.637, p = 0.001). Conclusion While this small-scale study has shown a relationship exists between critical care nurses’ critical thinking disposition and clinical decision-making in one hospital, further investigation using the same measurement tools is needed into this relationship in diverse clinical contexts and with greater numbers of participants. Critical care nurses’ perceived high level of critical thinking and decision-making also needs further investigation

The impact of tracheostomy timing (early & late) on severe head injury patients toward clinical outcomes

Severe head injury patients require a specific treatment plan and nursing care to achieve an optimal clinical outcome while 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

The association between social cohesion and community disaster resilience: a cross‐sectional study

A cross‐sectional study design was created, using the Index of Perceived Community Resilience (IPCR) and Buckner’s Index of Cohesion (BIC) to survey 386 flood evacuees from six communities in Kelantan, Malaysia, in 2015. The respondents were mostly female (54.7%); lived in basic housing (95.6%); average income (55.9%); secondary level schooling (81.1%); not involved with community organisations (95.1%), volunteering activities (91.2%), or emergency teams (96.9%); inexperience with injury during flooding (94%); experienced the emergency disaster (61.6%); and their mean age was 49 years old. Overall, respondents scored a high level of community disaster resilience (CDR) (mean 3.9) and social cohesion (mean 3.79). Also, respondents’ housing type, event of injury during disaster, volunteering in post‐disaster activities, and emergency team participation were significantly associated with CDR (p = 0.001– 0.002), organisational involvement (p = 0.016), and emergency disaster experience (p = 0.028) were significantly associated with social cohesion. The Pearson correlation coefficient results mostly showing a moderate, weak, and one with a strong relationship. There is a strong relationship between community participation (CDR) in events and BIC variables (r = 0.529, p = 0.001). Other analysis shows a moderate but significant relationship with BIC; is open to ideas (r = 0.332, p = 0.001); community has similar values/ideas (r = 0.421, p = 0.001); sense of pride (r = 0.389, p = 0.001); strong leadership (r = 0.339, p = 0.001); positive change (r = 0.484, p = 0.001); and able to handle problems (r = 0.454, p = 0.001). Overall, the results show that respondents had high levels of CDR and social cohesion, while the demographic characteristics show the impact of CDR and social cohesion. In conclusion, the data gives original insight into the level of association between social cohesion and disaster resilience, which could be used as a building block in sustainable disaster recovery. There is a need to explore this further on programmes designed to improve social cohesion across communities

Survey of Malaysian Critical Intensive Care unit nurses’ awareness of patients’transition experiences (PE) and transitionalcare practice (TCP)

careSummaryBackground: Preparation of critically ill patients throughout their transition experiences in Criti-cal Intensive Care Units (CICU) and following discharge can impact upon their recovery. However,there is little research addressing critical care nurses’ awareness of patients’ transition expe-riences.Aim: This study aimed to examine CICU nurses’ awareness of patients’ transition experiencesand transitional care practice in Malaysia.Method: A descriptive questionnaire was used to survey Registered Nurses in seven CICUs in fourhospitals in Malaysia. Data were analysed using descriptive statistics and correlation analysis.Results: The survey had a response rate of 65.2% (178 of 273 eligible nurses). The respondents’mean age was 29.6 years. Most of the respondents were from public hospitals and the majorityhad one to five years’ experience working as Registered Nurses, and in CICU. Public teach-ing hospital nurses had greater awareness of patients’ transition experience (PE) (p 10years Critical Intensive Care Unit experience (p 0.05). There was a positive correlation between nurses’ awareness of patients’ transi-tion experience and its impact, and their awareness of transitional care practice performance(rs= 0.42, p < 0.05).Conclusion: CICU nurses need targeted transition education to enable them to anticipate patients’ transitional experiences and to provide appropriate transitional care, particularly for public hospital nurses. Nursing schools need to integrate more content about critically ill patients’ transition experiences into the curriculum, to ensure graduate nurses will be able to anticipate the patient’s experience and provide appropriate transitional care

The family caregivers’ needs at home with severe traumatic brain injury survivor: a review

Background: The brain injury literature has focused primarily on victims of injury, reporting outcomes in terms of medical status, cognitive functioning, employment levels, and behavioural sequelae. However, in recent years, rehabilitation specialists have become increasingly concerned about the impact of traumatic brain injury (TBI) on family caregivers. The aim of this paper was to review the literature regarding the family caregivers’ needs at home with severe traumatic brain injury survivor. Methods: This paper reviewed search strategies in terms to find related article based on the past study on needs of family caregivers among severe traumatic brain injury survivor. The data for this review were based on 7 empirical studies published in scientific journals in 2010 - 2016, which were found in the EBSCOhost, Psych INFO, and ISI Web of Knowledge databases. The review include the study design, sample, method, and main result. Results: The findings in the included study, there are several points can be highlighted which the family caregivers needs who have been care the traumatic brain injury survivors’. It also reported on the needs of family caregivers on information, traumatic brain injury, TBI survivor complication, family caregivers’ burden, caregiver challenges and the impact of traumatic brain injury to family caregiver quality of life. Conclusions: Overall or the result on this study, family caregivers face significant challenges toward care of TBI survivors. The review highlight the support needs for family caregivers and it is important to know the facts about severe traumatic brain injury to understand the condition. The rehabilitation efforts need to take these result for further study

Undergraduate nursing students’ perceptions of the effectiveness of clinical teaching behaviours in Malaysia: a cross-sectional, correlational survey

Background: Clinical teachers are a critical determinant of the quality of nursing students’ clinical learning experiences. Understanding students’ perceptions of clinical teachers’ behaviours can provide the basis for recommendations that will help to improve the quality of clinical education in clinical settings by developing better clinical teachers. Objectives: To understand clinical teaching behaviours and their influence on students’ learning from the perspective of undergraduate nursing students. Design: A cross-sectional, correlational survey. Setting: A Nursing Faculty in Kuantan Pahang, Malaysia. Participants: A sample of 120/154 (78%) students from Year 2 – Year 4 were recruited according to set criteria. Methods: A self-administered questionnaire was employed to collect demographic data, and students’ perceptions of clinical teaching behaviours and their impact on learning using the Nursing Clinical Teaching Effectiveness Inventory (NCTEI). Results: Year 3 and 4 students perceived faculty clinical teaching behaviours positively. There was a significant association between clinical behaviours and their influence on students’ clinical learning. Teachers’ competence rated as the most significant influential factor, while teachers’ personality rated as least influential. Conclusion: Participants were able to identify good behaviours influencing their learning. Overall, they perceived their teachers as providing good clinical teaching, resulting in good clinical learning. Novice clinical teachers and nursing students can use this positive association between teaching behaviours and quality of clinical learning as a guide to clinical teaching and learning. Keywords: Clinical teachers, clinical teaching behaviours, undergraduate nursing students, quality of clinical learnin

Pharmacists' perception on medication errors in intensive care unit

Introduction:Medication error is a global issue. A medication error is one of the medical errors that can result from mild to severe complications which may violate patient safety. A holistic approach is important to prevent medication error includes contributed factor, reporting system and training for staffs. Objective:This research sought to determine the pharmacists' perception of medication errors in the intensive care unit. Methodology:This descriptive cross-sectional study involved 132 pharmacists from two hospitals in state of Pahang, Malaysia. A self-administrated questionnaire was used to collect the data. Statistical analysis of the data was carried out using SPSS and association between variables was analyzed using one way ANOVA and multiple regression tests. Result: The findings show that interruptions (x=̅3.40) as the commonest cause of dispensing errors perceived by pharmacists, followed by pharmacists fatigue at any cause (x ̅= 3.20) and pharmacist overwork (x=̅3.17). Besides, 51% of participants practice dispensing less than 10 hours per week on average. 54% and 55% of participants believe the increase of risk of error in dispensing and actual errors become more common in pharmacy practice, respectively. The results also showed that only level of education has a significant association with possible factors in dispensing medication among the pharmacists at the hospital (P=0.000). Besides, multiple regressions showed no significant relationship between both dependent variables. Conclusion: Most of the pharmacist perceived those possible factors associated with dispensing error. This study suggests that pharmacists should be well informed regarding dispensing error in order to be more alert. Besides, future study should be more specific on pharmacists who assigned to the in-patient department