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All Journal International Journal of Public Health Excellence (IJPHE) Malahayati International Journal of Nursing and Health Science
Mulyati, Leli
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Health Professions Medicine & Pharmacology Nursing Public Health

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Journal : Malahayati International Journal of Nursing and Health Science

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National early warning system adherence: Is nurses’ clinical competence involved associated with protocol in a hospital in Indonesia? Sasmito, Priyo; Ahmadi, Ahmadi; Mulyati, Leli; Prasetya , Fika Indah; Maryam, Andi; Sujana, Treesia; Tafwidhah, Yuyun; Elis, Andi
Malahayati International Journal of Nursing and Health Science Vol. 7 No. 2 (2024): Volume 7 Number 2
Publisher : Program Studi Ilmu Keperawatan-Fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v7i2.180

Abstract

Background: The implementation of the Early Warning System (EWS) in developing countries still faces many obstacles. The National Early Warning Score (NEWS) is one of the most frequently used EWS. The factors affecting its compliance are still being studied. Purpose: To analyze the involvement of nurse clinical competence in adherence to the National Early Warning Score (NEWS) protocol in a hospital in Indonesia. Method: This study is an observational analytic study with a cross-sectional approach to nurses in the medical ward. Nurse characteristics consisting of age, gender, education level, work experience, and knowledge of NEWS were measured and recorded. Nurse clinical competence level is the main independent variable. The outcome measured was nurse adherence to the protocol which was assessed by looking at the records in the NEWS observation sheet. Data was analyzed using Chi-Square, Fisher Exact Test, and Spearman Rho. Results: Thirty-five nurses were involved in the study. Respondent were 38.7 years old on average, had an average work experience of 7.1 years, and had an average knowledge of NEWS of 77.2+7.2 (good). The majority of respondent were females (20/57.1%), had diploma education (20/57.1), and were at clinical competency level I (26/74.3%). In the NEWS score < 5, most respondent adhered to the protocol (21/60.0%), but the majority did not adhere to the protocol at the NEWS score ˃.6 (28/80.0%). A p-value of > 0.05 was obtained in the analysis of the relationship between age, education level, and work experience with protocol adherence on a NEWS score of ˃.6 Conclusion: The majority of respondent have not adhered to the NEWS ˃.6 protocol. There is a significant relationship between age, education level, work experience, and NEWS ˃.6 protocol adherence. There was no relationship between nurses' clinical competence and adherence to the NEWS protocol at either a score of < 5 or ˃.6. Further studies are needed to confirm the results of this study.
Serious adverse events and missed observations impact of limited resources of nurses based on national early warning score (NEWS) Sasmito, Priyo; Mulyati, Leli; Prasetya, Fika Indah; Bernadus, Janno Berty Bradly; Sumartini, Sri; Arifani, Nisa; Tafwidhah, Yuyun; Ulfah, Diana
Malahayati International Journal of Nursing and Health Science Vol. 7 No. 4 (2024): Volume 7 Number 4
Publisher : Program Studi Ilmu Keperawatan-Fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v7i4.430

Abstract

Background: Since become an obligation for hospital, Early Warning System (EWS) are widely used. National Early Warning Score (NEWS) is common EWS adopted in Indonesia. There are not many studies evaluating the implementation of the in hospitals with limited resources in Indonesia. Purpose: To analyze the NEWS performance in the medical ward at one regional hospital in Serang District, Banten Province, Indonesia. Method: Observational analytic study with retrospective approach using NEWS observation sheet of 163 medical adult patients. NEWS's performance was assessed by analyzing the amount of observation that was not carried out in the first 24 hours of hospitalization according to hospital safety protocols. The observed outcome was the occurrence of serious adverse events (SAE), unplanned Intensive Care Unit (ICU) admission, and in-hospital mortality.  The data analyzed with Fisher Exact Test and Spearman Rho. Results: Participants' age mean of 48.2 years old (range 17-85). Most were male (87/53.4%) with a NEWS score of 0 in the first 24 hours of hospitalization (91/55.8%). Of 72 (44.2%) missed observation patients, 8 (4.9%) experienced SAE, 5 (3.1%) transferred to the ICU, and 3 (1.8%) died in the ward. There are significant relationship (p-value 0.001) between missed observation and the occurrence of SAE and unplanned ICU admission (p-value 0.015). There is no relationship between missed observation and in-hospital mortality. Conclusion: About forty percent of NEWS observation frequency in medical wards is still not under safety protocols that have been made by the hospital. Missed observation associated with SAE and unplanned ICU admission. Hospital stakeholders need to evaluate the implementation of NEWS in the hospital ward and take strategic action to increase its effectiveness.
Prehospital and in-hospital factors that influence acute stroke management in the emergency department: A literature review Sasmito, Priyo; Sumartini, Sri; Prasetya, Fika Indah; Mulyati, Leli; Haryanti, Eka; Darmawardana, Arif; Amalia, Linda; Munandar, Ihsan Haris
Malahayati International Journal of Nursing and Health Science Vol. 7 No. 6 (2024): Volume 7 Number 6
Publisher : Program Studi Ilmu Keperawatan-Fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v7i6.509

Abstract

Background: Effective emergency response plays a crucial role in ensuring patient safety, particularly in the management of acute stroke cases in Emergency Department (ED). Timely correct care is essential to mitigate adverse outcomes in stroke patient. Purpose: To investigates pre and in-hospital factors that influence acute stroke management in the ED. Method: A literature review method was employed to gather and analyze information from Scopus, Science Direct, and Google Scholar using the keyword stroke AND "Emergency Department" in the 2019-2024 period. As much as 333 articles are identified. A total of 10 articles that met the criteria were included in the study. The selected articles are then systematically reviewed and analyzed. Results: Factors that can affect prehospital delay consist of the use of Emergency Medical Services (EMS), patient characteristics, and geographical barriers. The factors that affect inhospital delay are communication with ED staff and ED officer knowledge. Conclusion: To improve the management of stroke patients, the participation of various parties is needed, not only within the hospital, but also the role of policy holders in the prehospital.
Co-Authors Ahmadi Ahmadi Aljufri, Salim Arifani, Nisa Bernadus, Janno Berty Bradly Darmawardana, Arif Deviana, Elina Diana Ulfah Elis, Andi Gayatri, Sri Wahyuni Haryanti, Eka Komariah, Elis Linda Amalia Maryam, Andi Munandar, Ihsan Haris Prasetya , Fika Indah Prasetya, Fika Indah Rasmita, Dina Sasmito, Priyo Sri Sumartini Syafridawita, Yetti Tafwidhah, Yuyun Treesia Sujana