Short Communication: Improving Timeliness of Analgesia for Acute Trauma-Related Pain in the Emergency Department Green Zone — A Quality Improvement Initiative

Gurjeet Singh a/l Harvendhar Singh — Thu, 01 Oct 2026 00:00:00 +0000

Background: Emergency Department (ER) overcrowding is a perennial issue in Malaysia. Non-critical, lower-acuity patients in the Green Zone often face long wait times, which frequently leads to institutional oligoanalgesia (delayed or inadequate pain relief). Objective: This short communication outlines a Quality Improvement (QI) work flow proposed by the author to clear departmental bottlenecks. The main target is to bump up the percentage of Green Zone patients with acute trauma-related pain who get their pain relief within 90 minutes of registration. This framework serves as a suggested model for other public hospitals looking to improve their ED throughput. Methodology: Using the Nominal Group Technique (NGT) and SMART prioritization criteria, the author evaluated key departmental issues and selected delayed pain management as the priority target. A strict Model of Good Care (MOGC) was designed to run through a rapid implementation timeline from July 2026 to August 2026. Data collection plans include pulling timestamps from the Electronic Health Record (EHR) system and handing out targeted questionnaires to frontline staff. Expected Outcomes: By sorting out the fragmented department layout, introducing decentralized analgesia sub-stores/carts directly inside the Green Zone, and conducting proper staff briefings, this model establishes a practical, sustainable work flow to hit our national KKM QA benchmark of ≥ 70% compliance.

Analysis of Factors Influencing the Adoption of Electronic Nursing Documentation: A SEM-PLS Approach

Thu, 15 Oct 2026 00:00:00 +0000

Background: The Indonesian Ministry of Health mandates the use of electronic medical records (EMRs) across all healthcare facilities, impacting hospitals nationwide, including those in Pekanbaru. In response, hospitals in Pekanbaru have integrated digital applications into healthcare services, including nursing care. Nursing documentation is now conducted using Electronic Nursing Documentation (END). Despite its implementation, no formal evaluation of END usage has been conducted, even though service effectiveness remains a key performance indicator. Objectives: This study aims to analyze factors influencing the adoption of END using a Structural Equation Modelling–Partial Least Squares (SEM-PLS) approach. Methods: This quantitative study employed a cross-sectional design and utilized a structured questionnaire. A total of 287 inpatient nurses from three hospitals in Pekanbaru were selected through purposive sampling. Data were analyzed using SEM-PLS techniques. Result: The structural model showed that perceived usefulness (POU) significantly influenced attitude toward using (ATU) (β = 0.749, p < 0.001) and behavioral intention to use (BITU) (β = 0.415, p < 0.001). Perceived ease of use (PEOU) significantly influenced ATU (β = 0.168, p = 0.010) and POU (β = 0.831, p < 0.001). ATU significantly influenced BITU (β = 0.490, p < 0.001) and actual usage behavior (AUB) (β = 0.464, p < 0.001), while BITU significantly influenced AUB (β = 0.479, p < 0.001). The model explained 82.7% of the variance in AUB. IPMA showed that POU had the highest importance for AUB (0.722), whereas PEOU had the highest performance (72.115). These results suggest that enhancing system usability and demonstrating its practical benefits can strengthen adoption intentions. Conclusion: The TAM creates significantly influenced END adoption, with POU being the strongest predictor of AUB and PEOU showing the highest performance. Future longitudinal studies applying objective usage measures are needed to authenticate these associations and explore additional determinants of adoption.

Malaysian Journal of Medical Research (MJMR)

Short Communication: Improving Timeliness of Analgesia for Acute Trauma-Related Pain in the Emergency Department Green Zone — A Quality Improvement Initiative

Analysis of Factors Influencing the Adoption of Electronic Nursing Documentation: A SEM-PLS Approach