Nurses In Malaysia Research Articles

A Knowledge Assessment of the Surgical Safety Checklist among Operating Room Nurses in Malaysia

Surgical complications present a significant challenge worldwide. To address this issue, the World Health Organisation (WHO) introduced the Surgical Safety Checklist (SSC) as a means to decrease complications and fatalities during surgery. Nurses play a critical role in ensuring patient safety throughout the operation. A clear understanding of the checklist promotes effective communication within the surgical team, fosters a safety culture, and reduces complications. However, limited research has been conducted in accessing knowledge of operating room (OR) nurses regarding SSC, especially in the context of Malaysian healthcare. Therefore, this study was conducted to evaluate the level of knowledge of SSC among OR nurses in Malaysia. A quantitative approach with a descriptive design was used, involving ninety (90) OR nurses from Sultan Ahmad Shah Medical Centre (SASMEC@IIUM). The nurses completed a self-administered questionnaire and the results revealed good knowledge of the preoperative phase checklist (68.9%), intraoperative phase checklist (73.3%), and postoperative phase checklist (77.8%). However, a minority of nurses (around 20–30% across three different phases) needed improvement. This study suggests that the SSC has been effectively implemented at SASMEC@IIUM. However, it also emphasises the importance of ongoing education to ensure that all nurses have a thorough understanding of the checklist.

Knowledge, attitude and practices about pharmacovigilance activities among hospital nurses: a multicentre cross-sectional survey.

The national pharmacovigilance (PV) system has been established in many countries worldwide following the thalidomide tragedy. Nurses have an important role in recognising and reporting any Adverse Drug Reaction (ADR); however, their role has not been widely explored, particularly in Southeast Asian countries. To assess the knowledge, attitudes and practice (KAP) about PV activities, along with barriers and facilitators that affect ADR reporting among hospital nurses in Malaysia. The present study also explores the relationship between demographic characteristics and predictors of KAP among hospital nurses in Malaysia. A multicentre, questionnaire-based, cross-sectional study was conducted in March-May 2021, among nurses working at tertiary care hospitals in Malaysia. The mean KAP score of study participants was 57 ± 11. Overall participants had poor ADR knowledge (37.4%), and poor reporting practices (48.9%). Age >30 years (AOR = 2.7 (1.13-6.8), p = 0.02), and working experience of greater than 10 years (AOR = 2.44 (1.08-5.52), p = 0.03), were significantly associated with good ADR knowledge and reporting practices among study participants. In summary, study findings offer valuable insight for developing targeted interventions and formal training to improve nurses' ADR knowledge and reporting practices. Addressing gaps in these areas can enhance patient safety and overall healthcare quality.

A Conceptual Framework on Factors Influencing Nurses’ Job Performance

The nurses' job performance can be regarded as a reflection of healthcare organizations, given that they comprise the largest group of human resource professionals who are responsible for providing high-quality care to patients. However, previous studies have emphasized that nurses in Malaysia are underperformed because of shortages in the workforce and excessive workload. Hence, understanding factors influencing the job performance of nurses will empower decision-makers to develop effective strategies aimed at enhancing nurses' performance. In Malaysia, only a few research have been performed on job performance, especially among nurses. Furthermore, limited research has delved into the specific factors influencing nurses’ job performance in Malaysia’s public hospital system. This study contributes to the existing knowledge by investigating the impact of spirituality at work and HRM practices on the nurses’ job performance in Malaysian public hospitals. This study employs a quantitative survey method using self-administered questionnaires, and the data collected will be analyzed using SPSS software Version 26. A total of 375 nurses from a population of 12, 514 nurses who worked at public hospitals in Malaysia will be selected as a sample of the study. This study offers potential benefits to authorities in Malaysian healthcare organizations by providing valuable insights for the development of compelling effective spirituality at work values and human resource management strategies aimed at enhancing the job performance of nurses.

Examining the Relationship between Job Satisfaction, Organization Commitment, and Turnover Intention Among Nurses in Malaysia

Examining the Relationship between Job Satisfaction, Organization Commitment, and Turnover Intention Among Nurses in Malaysia

Understanding the Association of Sleep Disorders with Nursing Productivity in Malaysia

This study examines the relationship between sleep disorders and productivity, specifically absenteeism and presenteeism, among nurses in Malaysia. The research objective is to assess the impact of sleep disorders on nurses' productivity by analyzing their absenteeism and presenteeism levels. This present study is correlational in design since it is intended to describe the relationship between sleeping disorders and nurses’ productivity. The study used stratified sampling to select the respondents from two private hospitals. The list of nurses was provided by the hospital management to facilitate the selection process. The questionnaire was personally distributed to the selected employees by the researchers. At the end of the data collection period, a total of 200 sets of the questionnaire were received, indicating a 100% response rate. The study's contribution lies in adding to the understanding of the crucial link between sleep disorders and productivity in the nursing profession. By emphasizing the adverse effects of sleep disturbances on nurses' efficiency, the research underscores the importance of targeted interventions and policy measures to support healthcare professionals' well-being and productivity. The implications extend to healthcare management and policymakers, urging them to prioritize sleep health and consider strategies that mitigate the impact of sleep disorders on nursing staff. To advance this field, future research should focus on larger sample sizes and diverse populations to comprehensively explore the broader implications of sleep disorders on productivity. Such studies can lead to more effective measures for improving the work environment, reducing absenteeism, and enhancing overall patient care and outcomes.

Commuting Accidents and Its Associated Factors Among Public Hospital Nurses in Selangor, Malaysia.

Commuting accidents account for 48% of work-related accidents in Malaysia. However, commuting accidents among health care workers are understudied and formally reported commuting accident numbers among nurses are likely to be an underestimate of actual numbers. This is the first study in Malaysia to attempt to establish the true incidence and associated factors for commuting accidents among nurses in Malaysia. A cross-sectional study was conducted to determine the true incidence of commuting accidents and its associated factors among public hospital nurses in Selangor, Malaysia. A validated and pilot-tested self-reported questionnaires were distributed to all nurses via an online-based platform. This study found a significant difference between the incidence of formally reported and self-reported commuting accidents from 2018 to 2022, with incidence rates ranging between 0.3 and 8.6 per 1000 nurses. Multivariable logistic regression showed that nurses working in district hospitals had lower odds to be involved in commuting accidents, while nurses working in clinical departments and traveling longer distances between home and workplaces had increased odds of commuting accidents.

Critical Care Nurses’s Knowledge and Attitude Towards Sleep Promoting Interventions Among Critically Ill Patients in Intensive Care Unit

Introduction: Sleep promotion in the Intensive Care Unit (ICU) should be a priority because interruptions may prevent patients from getting enough sleep. Inadequate sleep might lead to delirium, anxiety, increased hospital stays, and higher mortalities. Critical care nurses with good knowledge and attitude towards sleep promotion interventions benefit critically ill patients’ quality of care and life. Critical illness, pain, mechanical ventilation, surroundings, and nurses’ activity at night contribute to sleep disturbances in ICU patients. The aim of this study was to determine critical care nurses’ knowledge regarding the physiology of sleep, interventions to promote sleep, attitude towards sleep, and sleep promotion. Methods: A cross-sectional study with a self-administered questionnaire and purposive sampling method was conducted among 109 critical care nurses at the ICU of a teaching hospital. Results: The mean score knowledge of critical care nurses was 4.72 (± 1.92), attitude towards sleep was 18.57 (± 3.56), and intervention towards sleep promotion was 70.00 (± 12.00). A significant correlation was observed between knowledge and attitude (p < 0.05, r = 0.22) and between attitude and intervention (p < 0.05, r = 0.32), indicating a modest correlation. Moreover, a significant association was noted between years of experience and attitude and intervention (p < 0.05). Conclusion: Critical care nurses’ knowledge, attitudes, and interventions were poor; hence, they need to improve their knowledge, attitude, and interventions. The significance of sleep promotion and factors leading to critical care nurses in Malaysia not promoting sleep among ICU patients needs to be rectified.

PSYCHOMETRIC PROPERTIES OF THE EMERGENCY PREPAREDNESS INFORMATION QUESTIONNAIRE AMONG NURSES IN MALAYSIA.

Background: Nurses' knowledge, skills and competencies are paramount for their preparedness to respond to emergency situations. This paper aims to test the psychometric properties and to determine the factor structure of the Emergency Preparedness Information Questionnaire (EPIQ) among nurses in Malaysia. Methods: There were 418 nurses in Sabah, Malaysia participated in this study. Besides, EPIQ, The Nurse Assessment of Readiness scale and the self-regulation scale were used to the validity of EPIQ. Results: The study revealed that the nine dimensions of EPIQ demonstrated very good reliability and construct validity. All the items showed good intercorrelation. The result of Exploratory Factor Analysis revealed a 3-factor solution model of EPIQ. The first factor was recategorized into four sub-factor due to the large number of the items loaded in this factor. Conclusions: The findings revealed that the EPIQ has strong psychometric properties. This scale can be used to measure nurses' preparedness in managing the emergency event in Malaysia.

The Mediating Role of Moral Disengagement in Predicting Deviant Workplace Behavior Among Nurses in Malaysia

Background: The healthcare environment is becoming increasingly competitive to meet patients’ expectations and demands. Despite the nurses’ best efforts to provide the finest services, they often receive complaints from people dissatisfied with the services they receive. There are reports claiming nurses as violent and unethical in their duties. This condition causes constant stress among nurses, translating into trait anger and negative affect. The present work aimed to examine the influence of trait anger and negative affectivity on deviant workplace behavior with the mediating role of moral disengagement. Methods: This cross-sectional correlational study was conducted in the general hospitals of the northern, southern, east coast, and central Malaysia’s regions from January to June 2020. The study sample included 387 nurses recruited by proportionate stratified random sampling. The data were collected using negative affect scale, deviant workplace behavior scale, trait anger scale, and moral disengagement scale. Then, the obtained were analyzed using partial least squares path modeling (PLS-PM) with SMART PLS software, version 3.2.8. Results: The results of the PLS-PM suggested that trait anger contributes to deviant workplace behavior (β=0.245, P=0.001). Also, this study discovered that moral disengagement mediates the relationship between trait anger, negative affectivity, and deviant workplace behavior among nurses. Conclusion: This study enriches the knowledge of deviant workplace behavior in healthcare settings, specifically Malaysia’s public healthcare sector. In the future, similar studies should be performed in private hospitals to improve the generalisability of the findings.

Medication administration errors reporting by Neonatal Intensive Care Nurses in Malaysia: A nationwide study

Aim: To determine the willingness and barriers of Neonatal Intensive Care Unit (NICU)-based nurses in Malaysian hospitals in reporting medication errors. Background: Reporting incidents is important in improving patients’ safety and developing a healthy culture of learning from mistakes. Method: Three self-developed scenarios, ranging from mild, moderate to severe medication administration errors, were used to identify nurses’ willingness to report an error. A validated questionnaire assessing barriers to reporting errors was adapted. The sample size calculated was 139. All 22 NICUs in government-funded hospitals were approached. Nurses were randomly recruited and given a URL to access the online questionnaire. Results: Of 182 nurses from 15 hospitals who participated, 91.2% (n=166) were willing to report medication errors and patient safety was the main concern to report it. Among the nurses (n=16, 8.8%) who chose not to report medication errors, they were worried about getting into trouble (87.5%), information being shared with managers (56.3%), disciplinary actions and medico-legal issues (50.0%). Conclusion: Most NICU nurses were willing to report a medication error, and the barriers to the minority of them not reporting should be given attention. Implications: Reassurance by the managers for not penalizing the nurses who report an error should be emphasized in the incident reporting policy.

Burnout and coping strategies among nurses in Malaysia: a national-level cross-sectional study

ObjectiveThis national-level study aimed to determine the prevalence and risk factors of burnout, as well as the coping strategies among nurses in the Ministry of Health (MOH) Malaysia.DesignUsing a complex...

I Am Not Just a Nurse: The Need for a Boundaried Ethic of Care in the Context of Prolific Relationality

The Ethics of Care (EoC) theory has been widely applied in the field of management, and there is a growing consensus that it is important to recognise the value and practice of care in the workplace. In this paper, we consider the implications of the EoC at work, and in particular the risks unboundaried care demands may pose to employees who encounter unmanageable ‘calls to care’. We present findings from interviews with 27 nurses in Malaysia, which suggest that the demand to care at work, in addition to demands made in the non-work sphere, may be unmanageable. We argue for a more boundaried approach to the EoC at work with a view to ensuring that in valuing care we do not over-burden the carer.

Validation of the Measurement Model of the Grief Support Healthcare Scale Among the Intensive Care Unit Nurses in Malaysia.

This study aimed to establish the validity and reliability of the measurement model of the Grief Support Healthcare Scale sub-constructs among the intensive care unit (ICU) nurses. This methodological study in January 2015 uses the TRIPOD checklist for model validation. A two-order confirmatory factor analysis involving 655 nurses from the adult ICUs of nine hospitals confirmed the validity and reliability of the sub-constructs of grief support. The evaluation of the measurement model was based on the multi-category model fit indices. The convergent and discriminant validities and reliability of the grief support sub-constructs, recognition of the relationship, acknowledgment of the loss, and inclusion of the griever were confirmed, with eight indicators. The measurement model of the revised Grief Support Healthcare Scale had a good model-fit (chi-square (df) = 67.586(17); p = .000; relative chi-square = 3.976; AGFI = 0.947; GFI = 0.975; CFI = 0.990; IFI = 0.990; TLI = 0.984; RMSEA = 0.067; SRMR = 0.020). The validated grief support measurement model allows measurement of grief support for future intensive care unit nurses and the structural model analysis. Nurse managers and co-workers provide support to the grieving intensive care unit nurses based on the essential components of grief support.

Beliefs about the Benefits and Barriers to Physical Activity Promotion for Cancer Patients among Nurses in Malaysia

Introduction: Physical activity (PA) can improve survival and quality of life in chronic diseases including cancer. Given the scarcity of research on nurses’ beliefs that used a psychology perspective, the purpose of this study was to determine nurses’ beliefs about the benefits and barriers to physical activity promotion for cancer patients at a tertiary teaching hospital in Malaysia. Methods: A cross-sectional study was performed on nurses (n=104) at one Malaysian tertiary teaching hospital, using a simple random sampling method. A self-administered online questionnaire was surveyed from January until March 2021. The data was analysed using Pearson correlation analysis and an independent T-test with a significant level of p ≤.0.05. Results: 80.8% of nurses perceived the benefits of physical activity promotion for improving mental health in cancer patients. Lack of time (30.8%), patients appearing tired or unwilling to cooperate (20.2%), and a lack of knowledge (16.3%) were the barriers to physical activity. There was no correlation between beliefs about the benefits of physical activity promotion and age (p=0.908), working experience (p=0.982), ward type (p=0.666) or the average number of cancer patients cared (p=0.144). Conclusion: Nurses’ perspectives on the benefits of physical activity promotion for cancer patients support the use of planned behaviour theory for evidence-based nursing practice. There were, however, barriers to encouraging cancer patients to engage in physical activity. As a result, as a setting for health promotion, the tertiary teaching hospital must raise awareness, facilitate, and encourage nurses to engage in physical activity promotion behaviours.

EMPATHY AND COMPETENCY AS PREDICTORS OF NURSES' JOB PERFORMANCE: AN EMPIRICAL EVIDENCE FROM MALAYSIAN PUBLIC HOSPITALS


 
 
 Nurses act as customer-contact employees who are responsible for providing round-the-clock service to patients. Their empathy and competency skills have a significant impact on the quality of services provided to patients. The purpose of this study is to examine the role of empathy and competency in determining task performance and contextual performance of public hospital nurses in Malaysia. A survey using self-administered questionnaires was used to collect data from a sample of 354 staff nurses working in Malaysian public hospitals. Hypotheses were tested using the partial least square technique. Findings indicated that empathy has a positive relationship with task performance but not with contextual performance. Competency, however, has a positive relationship with task performance and contextual performance respectively. Empathy and competency are essential elements in predicting both task performance and contextual performance. The findings of this study highlighted the importance of empathy and competency in improving job performance among nurses in Malaysian public hospitals.
 
 

Self-directed learning readiness among nurses in Malaysia

<p class="Abstractandkeywords"><span lang="EN-US">Self-directed learning is one of the important skills for nurses. The readiness to be self-directed in learning enhances nursing professional development and life-long learning. This study aims to determine the level of self-directed learning readiness among nurses at a selected hospital in Malaysia. The conceptual framework for the study is based on the concepts of self-directed learning readiness. This is a cross-sectional quantitative study using descriptive and correlational method for data analysis. A simple random sampling technique was employed to recruit 145 nurses. The Self-Directed Learning Readiness Scale (SDLRS) was adopted to measure the variables of the study. The findings of the study revealed a high level of self-directed learning readiness among nurses (M = 161.71, SD = 12.60). The highest subscale of SDLR was self-control (M=58.22, SD= 4.78) followed by self-management (M=53.99, SD= 4.92) and desire for learning (M=49.51, SD= 4.63). There is a statistically significant difference between age, academic qualification, and self-directed learning readiness (p< 0.05). This study highlights the important concepts of self-directed learning for nurses. The role of educators and administrators is essential to support nurses for self-direction in higher education. Future studies to explore barriers from self-directed learning are recommended.</span></p>

Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training.

Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for nurses in Malaysia. Hence, this study aims to design a CPG for the process of weaning from mechanical ventilation (MV) for a structured nursing training in a CICU at the National Heart Institute (Institut Jantung Negara, IJN) Malaysia. The Fuzzy Delphi Method (FDM) was employed to seek consensus among a panel of 30 experts in cardiac clinical practice on the guidelines. First, five experts were interviewed and their responses were transcribed and analyzed to develop the items for a FDM questionnaire. The questionnaire, comprising of 73 items, was distributed to the panel and their responses were analyzed for consensus on the design of the CPG. The findings suggested that the requirements expected for the nurses include: (a) the ability to interpret arterial blood gases, (b) knowledge and skills on the basics of mechanical ventilation, and (c) having a minimum 1-year working experience in the ICU. On the other hand, the CPG should mainly focus on developing an ability to identify criteria of patient eligible for weaning from MV. The learning content should focus on: (a) developing the understanding and reasoning for weaning and extubating and (b) technique/algorithm for extubating and weaning. Also, the experts agreed that the log book/competency book should be used for evaluation of the program. The CPG for structured nursing training at IJN in the context of the study is important for developing the professionalism of CICU nurses in IJN and could be used for training nurses in other CICUs, so that decision for ventilator-weaning from postcardiac surgery could be expedited.

Job satisfaction of foreign-educated nurses in Malaysia: A cross-sectional study.

The transition process of migration to work abroad can be challenging and, depending on how it is handled, can impact the job satisfaction level of these foreign-educated nurses. A clear understanding of migrant nurses' job satisfaction is critical for effective translation of nursing practice across the health systems and cultures. This study examined the job satisfaction of the foreign-educated nurses in Malaysia, which includes the job satisfaction dimensions and the significant difference between sociodemographic status and job satisfaction. A cross-sectional survey of 102 foreign-educated nurses working in private hospitals, clinics, hemodialysis centers, nursing homes, and private homes in Malaysia was conducted from September 2017 to March 2018. Data were collected using a structured questionnaire. Descriptive statistics, Mann-Whitney U, and Kruskal Wallis tests were used to analyze the data. The study revealed that the participants had a median satisfaction score of 22 (IQR = 19 to 24). Serving the sick and needy and participants' self-respect were the highest satisfaction dimensions among the participants (Median = 3, IQR = 3 to 3). Moreover, the job satisfaction was significantly higher for registered foreign-educated nurses (mean rank = 62.5) than for unregistered foreign-educated nurses (mean rank = 48.65) when working in other countries (p = 0.02). Indian nurses (mean rank = 60.36) also expressed higher satisfaction in terms of working in other countries than Filipino nurses (mean rank = 46.88; p = 0.02). In addition, positive relationships with colleagues and superiors led to higher satisfaction among Indian nurses (mean rank = 61.02) than among Filipino nurses (mean rank = 47.24; p = 0.04). The job satisfaction of male foreign-educated nurses was significantly higher than their female counterparts in terms of self-respect, relationship with fellow nurses and superiors, working in other countries, career development, and ease of finding employment (p < 0.05). The overall job satisfaction among the foreign-educated nurses in Malaysia is high, mainly when serving the sick and needy, and their degree of self-respect. Understanding job satisfaction among foreign-educated nurses in Malaysia enables the management team to develop effective strategies for addressing nursing shortages and improving the quality of patient care.

Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience.

Blood transfusion is a fundamental and life-saving procedure where the consequence of errors can be fatal. Nurses’ knowledge plays an essential role in ensuring quality and safety in blood transfusion. The objective of this study was to assess blood transfusion-associated knowledge of tertiary hospital nurses on the east coast of Malaysia. This was a cross-sectional study with 200 registered nurses involved in blood transfusion procedures at Hospital Universiti Sains Malaysia. The knowledge of the nurses was evaluated by using the routine blood transfusion knowledge questionnaire based on five parts, and <50%, 50–74%, or ≥75% of the knowledge was considered as poor, moderate, or high, respectively. Based on the scoring system, the overall knowledge of blood transfusion among Malaysian nurses (33.2 ± 8.4 years) was estimated to be 54.9 ± 7.6%. In individual items, the scoring was 81.0%, 45.4%, 49.2%, 63.0%, and 90.0% in knowledge prior to blood transfusion, on pre-transfusion, on post-transfusion, on complications, and on transfusion policy, respectively. The findings of this study indicated that most of the nurses’ overall knowledge of blood transfusion was at a moderate level; therefore, training courses and continuous medical education are warranted to improve knowledge and skills of the nurses to ensure good practices of blood transfusion.

The COVID-19 Global Pandemic and Its Impact on the Mental Health of Nurses in Malaysia.

The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic.