1.Translation And Validation Of The Malay Post Traumatic Stress Disorder Checklist For Civilians
Rafidah Bahari ; Muhammad N Mohamad Alwi ; Muhammad R Ahmad ; Ismail Mohd Saiboon
ASEAN Journal of Psychiatry 2015;16(2):1-9
Objectives: There are a number of validated questionnaires available for the
screening of Post-Traumatic Stress Disorder (PTSD), and the PTSD Checklist
for Civilians is one of them. However, none was translated into the Malay
Language and validated for use in the Malaysian population. The aim of this
study is to translate and validate the Malay PTSD Checklist for Civilians
(MPCL-C). Methods: The PCL-C was translated into the Malay Language and
back-translated. The reliability and validity of the MPCL-C were then
determined by administering them to those who presented at the emergency
department for motor vehicle accident at least one month before. Results: The
MPCL-C has good face and content validity. In terms of reliability, it is also
good, with Chronbach’s alpha values of 0.90, 0.77, 0.75 and 0.74 for the full
scale, re-experiencing, avoidance and arousal domains respectively. Conclusions:
The MPCL-C is a valid and reliable instrument to screen for PTSD in motor
vehicle accident victims for the studied population.
2.Clinical Pathways: Development and Implementation at a Tertiary Hospital in Malaysia
Aniza Ismail ; Saperi Sulung ; Syed Mohamed AlJunid ; Nor Hamdan Mohd Yahaya ; Husyairi Harunarashid ; Oteh Maskon ; Andrea Ban ; Roslan Harun ; Ismail Mohd. Saiboon ; Ikafaizura Mohd. Nor
International Journal of Public Health Research 2012;2(2):153-160
Clinical pathways have been implemented in many healthcare systems with mix results in improving the quality of care and controlling the cost. CP is a methodology used for mutual decision making and organization of care for a well-defined group of patients within a well-defined period. In developing the CPs for a medical centre, several meetings had been carried out involving expert teams which consist of physicians, nurses, pharmacists and physiotherapists. The steps used to develop the pathway were divided into 5 phases. Phase 1: the introduction and team development, Phase II: determining the cases and information gathering, Phase III: establishing the draft of CP, Phase IV: is implementing and monitoring the effectiveness of CP while Phase V: evaluating, improving and redesigning of the CP. Four CPs had been developed: Total Knee Replacement (TKR), ST Elevation Myocardial Infarction (AMI), Chronic Obstructive Airways Diseases (COAD) and elective Lower Segment Caesarean Section (LSCS). The implementation of these CPs had supported the evidence-based medicine, improved the multidisciplinary communication, teamwork and care planning. However, the rotation of posts had resulted in lack of document ownership, lack of direction and guidance from senior clinical staff, and problem of providing CPs prior to admission. The development and implementation of CPs in the medical centre improved the intra and inter departmental communication, improved patient outcomes, promote patient safety and increased patient satisfaction. However, accountability and understanding of the CPs must be given more attention.
Critical Pathways
;
Quality of Health Care
;
Evidence-Based Medicine
;
Health Care Costs
;
Interdisciplinary Communication
3.A Study of House Officers in a Teaching Hospital on Knowledge, Perception of Skills and Confidence Level in Performing CPR
Ismail Mohd Saiboon ; Noraliza Mohd Ariffin ; Teodoro Javier Herbosa ; Ahmad Khaldun Ismail ; Nariman Singmamae ; Shamsuriani Md Jamal ; Azhana Hassan ; Ho Siew Eng
Medicine and Health 2007;2(2):110-116
Cardio-pulmonary Resuscitation (CPR) is important and should be mastered by House
Officers (HO). House officers who have just completed their studies are assigned to acute medical and surgical wards. If a patient in the ward has a cardiac arrest (CA), these
doctors are usually the first to attend. Therefore an HO must be confident with CPR skills.
They must be competent in performing CPR. The authors assessed 26 new HOs from
Universiti Kebangsaan Malaysia Hospital (HUKM) with respect to their self-perception
about CPR skills, confidence level in performing CPR and knowledge in performing CPR.
Knowledge was assessed by a questionnaire. We found that 16 of 26 (61.5%) assessed
themselves to have inadequate knowledge and 46.2% had no confidence in performing
CPR. The mean score of the written test was 5.7 ± 1.8. Seven out of 26 (27.0%) HOs had
incorrect hand placement position for CPR. Only 4 and 9 out of 26 HOs had their sternal
paddle and cardiac apex paddle positions correctly placed respectively. In conclusion,
knowledge, perception of skills and confidence levels of HOs on CPR are inadequate and
need further assessment and improvement. Medical schools need to review their CPR
curriculum in order to prepare HOs adequately to work in emergency situations.
4.Evaluation of time-dependent pathways in an acute ischemic stroke protocol that incorporates CT perfusion: A tertiary referral center experience
Hilwati Hashim ; Radhiana Hassan ; Syazarina Sharis ; Shahrul Azmin ; Rabani Remli ; Shahizon Azura Mukari ; Nafisah Yahya ; Hui Jan Tan ; Norlinah Mohamed Ibrahim ; Mohd Saiboon Ismail ; Sobri Muda ; Ramesh Sahathevan
Neurology Asia 2013;18(4):355-360
Background and Objective: Intravenous thrombolysis service for stroke was introduced at the Universiti
Kebangsaan Malaysia Medical Centre (UKMMC) in 2009, based on the recommendations of a
multidisciplinary team of clinicians. We report the experience at our center in establishing a stroke
protocol incorporating computed tomography perfusion (CTP) of the brain, to assess the feasibility
of incorporating CTP in the stroke protocol.
Methods: A retrospective review of all patients who had a CTP between January 2010 and December
2011 was performed. Results: Of 272 patients who were admitted with acute ischemic stroke, 44
(16.2%) arrived within 4.5 hours from symptom onset and had a CTP performed with the intention to
treat. The median time for symptom-to-door, symptom-to-scan and door-to-scan was 90.0 minutes (62.5
– 146.3), 211.0 minutes (165.5 – 273.5) and 85.0 minutes (48.0 – 144.8) respectively. Eight patients
(2.9%) were thrombolysed of whom five received IV thrombolysis and three underwent mechanical
thrombolysis. The median symptom-to-needle and door-to-needle times were 290.5 minutes (261.3
– 405.0) and 225.0 minutes (172.5 – 316.8) respectively. Four patients were thrombolysed despite
being outside the window of treatment based on the CTP findings. Six of the thrombolysed patients
had a Modified Rankin Score (MRS) of 1-2 at 5 months post procedure.
Conclusions: CTP provides a benefit to management decisions and subsequent patient outcome. It is
feasible to incorporate CTP as a standard imaging modality in a stroke protocol. The delays in the
time-dependent pathways are due to our work flow and organisational process rather than performing
the CTP per se.