Information regarding out of hospital cardiac arrest incidence including outcomes in Malaysia is limited and fragmented. This study aims to identify the incidence and adherence to protocol of out of hospital cardiac arrest and also to explore the issues faced by pre-hospital personnel in regards to the management of cardiac arrest victim in Kuala Lumpur, Malaysia. A mixed method approach combining qualitative and quantitative study design was used. Two hundred eighty five (285) pre-hospital care data sheet for out of hospital cardiac arrest during the year of 2011 were examined by using checklists to identify the incidence and adherence to protocol. Nine semi-structured interviews and two focus group discussions were performed. Based on the overall incidence for out of hospital cardiac arrest cases which occurred in 2011 (n=285), the survival rate was 16.8%. On the adherence to protocol, only 89 (41.8%) of the cases adhered to the given protocol and 124 did not adhere to such protocol. All the relevant qualitative data were merged into few categories relating to issues that could affect the management of out of hospital cardiac arrest performed by pre-hospital care team. The essential elements in the handling of out of hospital cardiac arrest by pre-hospital care teamwasto ensure increased survival rates and excellent outcomes. Measures are needed to strengthen the quick activation of the pre-hospital care service, prompt bystander cardiopulmonary resuscitation, early defibrillation and timely advanced cardiac life support, and also to address all other issues highlighted in the qualitative results of this study.

Background: In a nursing programme, the main objective is to produce nursing graduates who can provide comprehensive care and treatment to the community. A good approach to the systematic design of a learning environment can lead to positive outcomes for graduates. The learning environment is more than student-teacher interaction, teaching and learning activities. Good physical structures and facilities provided by the university are important, too. Furthermore, the university must also be concerned about meeting students’ psychosocial and emotional needs. The aim of this study is to measure the learning environment by administering the Dundee Ready Educational Environment Measure (DREEM) questionnaire to students across the four years of the Bachelor of Nursing programme at the Faculty of Nursing, IIUM, and to identify areas for change that may contribute to a more meaningful student learning experience. Methods: The DREEM questionnaire was administered to 105 Bachelor of Nursing students at IIUM. Results: The total mean score on the 50-item DREEM inventory was 120.12 out of a maximum of 200. Student perceptions of learning and their teachers, their academic self, social self and their perception of the atmosphere were all positive. Eight items with low mean scores (less than two) on the DREEM questionnaire were identified as requiring remediation. Conclusion: The implications include the need to create and maintain a supportive environment, in addition to designing and implementing interventions to remedy unsatisfactory elements of the learning environment if effective and successful teaching and learning are to be realised. Thus, specific remedial steps to improve the student learning environment of the Faculty of Nursing, IIUM are described.

Breast self-examination (BSE) is recommended globally as one of the methods in early detection of breast cancer. Little is known about nurses screening behavior related to BSE. A cross-sectional study was conducted to examine the knowledge, attitude and practice of Breast Self Examination (BSE) among nurses. A self-administered questionnaire was sent to a total of 114 nurses working in Obstetrics & Gynaecology wards and clinics of two tertiary hospitals. Among the 114 participants, 111(97.4%) practiced BSE. The mean age of the participants was 34.97(±9.104) years. The mean score of knowledge was 11.07(±1.020) and 81.1% had high knowledge of BSE. Majority (98.2%) of respondents showed good attitude towards BSE. Barriers was found to be a significant predictor and self confidence proved to be an influencing factor on BSE performance. Despite practicing BSE, the number of nurses that examined their breast monthly was only 35.1%. Age, working experience and marital status showed no significant relationship with knowledge and practice of BSE. However, BSE taught during their undergraduate programme was found to have a significant relationship with practice of BSE. Majority of nurses in this study were not complying with MOH recommendation for BSE in terms of frequency. Thus, intervention strategies should focus on educating nurses on performing BSE monthly, in accordance with the Ministry of Health guidelines. This is important as nurses play a primary role in promoting health behaviors in BSE practice and breast cancer awareness among women in this country.