Ambulance response time is one of the key performance of ambulances services. The objective of this study is to determine the factors associated with delayed ambulance response time in Hospital Universiti Sains Malaysia (HUSM). This was a cross sectional study conducted in Department of Emergency Medicine, Hospital Universiti Sains Malaysia (EDHUSM) between January 2016 to January 2017. A total of 300 ambulance calls were included in our analysis. Data were collected by ambulance paramedic using validated ambulance form. All ambulance forms with missing data were excluded from this study. Of the 300 ambulance calls within the study periods, 254 cases (84.7%) were determined to have delayed ambulance response time. Current ambulance response time is 14 minutes with interquartile range of 5 minutes. Factors which showed significant association delayed ambulance response time include distance from hospital, location, type of emergency and ambulance mechanism. The odd of delayed ambulance response time by every increase in distance unit was 1.59 (95% CI, 1.37 to 1.85). For location type, the odd of delayed ambulance response time for public location as compared to road was 0.13 (95% CI, 0.04 to 0.45). For ambulance mechanism, the odd of delayed ambulance response time for beacon type as compared to siren type was 0.22 (95% CI, 0.01 to 0.69). Further intervention should be initiated based on our findings to improve current ambulance response time.

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.