Evaluation of staff education on ventilator bundle compliance in university Kebangsaan Malaysia medical centre [UKMMC] intensive care unit [ICU]

Ventilator associated pneumonia [VAP] has been associated with high morbidity and mortality rates especially in critically ill patients. Implementing the "ventilator bundle" series of interventions serves a pivotal role in reducing the incidence of VAP. This study was carried out to review compliance of the staff in UKMMC ICU towards ventilator bundle from August 2010 to March 2011. All medical and nursing staffs in ICU were given education by means of lectures, pamphlets, posters, and refresher sessions which were implemented in between two periods of assessment Compliance was assessed on daily basis at random throughout a 140-day course divided into 70 pre-educational days and 70 post-educational days. Pre-educational overall compliance achieved was 38.4%. Compliance of individual component was: [1] head of bed [HOB] > 30 degrees: 43.6%, [2] Peptic ulcer disease [PUD] prophylaxis: 88.6% [3] Deep venous thrombosis [DVT] prophylaxis: 86.7% [4] Sedation vacation: 98.1% [5] Oral care: 96.7%. Post-educational overall compliance achieved was 65.0% with each individual component achieving 67.6%, 97.7%, 89.6%, 97.4%, and 99.0% respectively. There were statistically significant increases [p<0.05] in overall compliance and 3 individual components i.e. HOB elevation, PUD prophylaxis and oral care. Implementation of education had resulted in improved compliance of some, but not all components of the ventilator bundle. Continuous staff education is recommended to ensure further improvement and maintenance in compliance amongst the multidisciplinary team who manage patients in ICU

Anxiety and depression in patients with coronary heart disease: a study in a tertiary hospital

Anxiety and depression could reduce the quality of life, and exacerbate physical symptoms and even mortality amongst patients with coronary heart disease [CHD]. The aim of this study was to investigate the incidence of anxiety and depression in patients with acute CHD. In a period from March to December 2008, the views of 108 CHD patients, hospitalized in a tertiary hospital, were solicited using Hospital Anxiety and Depression hospital, were solicited using Hospital Anxiety and Depression Scale [HADS] and sociodemographic questionnaires. Patients with CHD had a low level anxiety and depression scores. There was significant differences in the total HADS score of participants stratified for marital status [P=0.027] or co-morbidity of diseases [P=0.012]. Also, there were significant differences in the scores of depression subscale stratified for marital status [P=0.021] or co-morbidity of disease [P=0.007]. However, there was no significant difference between the total HADS score or depression subscale score of the participants stratified based on age, gender, race, education, or income. Moreover, unmarried CHD respondents possessed higher depression level compared to the married respondents, and CHD respondents with co-morbid diseases showed a high level of depression. The findings might be taken as evidence to suggest that CHD patients should be evaluated early for the detection of anxiety and depression for appropriate referral and support

A Study of Patients’ Satisfaction with the Emergency Department (ED) of Hospital Universiti Kebangsaan Malaysia (HUKM)

Patients’ satisfaction is of critical interest to all healthcare providers. Satisfied patients are more likely to seek health care and to comply with prescribed treatment regimes. The objective of the study was to identify factors that influence patient satisfaction with Emergency Department HUKM (ED HUKM). This study was conducted at ED HUKM from January 2007 till March 2007. A convenience sample of 100 participants was recruited from triage 4. The Davis Consumer Emergency Care Satisfaction Scale (CECSS) was adopted and modified. It consists of 19 questions; used a 5 point, Likert type scale of 1 to 5 (1= completely disagree and 5= completely agree) to measure patient satisfaction with triage, health care providers caring behaviours and health teaching. Results showed that 75 participants (75%) were satisfied. There were no significant difference found between male and female patients with total CESCC scores (t=0.308, p values >0.05). Pearson product moment correlation coefficients showed a positive relationship between total and subscale patient satisfaction scores, caring scores (r=0.905, p value <0.05) and teaching scores (r=0.695, p < 0.05). Overall, patients were satisfied with services at the ED HUKM. Patients’ satisfaction remains as an important quality outcome measure of emergency care in any hospital.