Diarrhea Risk Factors of Infant and Children Under Five Years in Indonesia: a Systematic Review of Public Health Academic Studies

Diarrhea is one of the national public health problems most researched academically in the school of public health. This systematic review research aimed at exploring risk factors of diarrhea involved 18 academic products in the form of graduate thesis and undergraduate final academic paper of School of Public Health University of Indonesia in the year 2000-2005. The subjects (3884, ranging from 65 to 500) of these academic research products were mothers, infants, and children under age of 5. Data were analyzed univariate & bivariate. Most of the literatures used as reference in these research were old diarrhea reference books, publication from Ministry of Health and previous academic research results (i.e. thesis and final academic paper). None of the research instruments reviewed was tested its validity and its realibility. Risk factors most researched were related to environmental factor, i.e. clean water & toilet. The significant mother’s risk factors were knowledge, behaviour and hygiene. The significant children’s risk factors were nutritional status & brestfeeding. Environmental risk factors associated with access to clean water were source of clean water (average OR=3.19), risk of being contaminated (average OR=7.89), and ownership of the clean water source (average OR=17.25). By t-test, the differences between thesis and undergraduate final academic paper were number of independent variables & literature references used. Overall, the quality of academic research products is not sufficiently qualified

Analysis of Policy Making Factors on The Prohibition of Hormones and Antibiotics Use for Feed as a Public Health Protection

Food safety is one of the current international emerging issues. The danger of using antibiotics in animal husbandry is one of the contributors to human resistance. In Indonesia, antibiotics are commonly used as growth promoters in animal husbandry. Prohibition on the use of hormones and antibiotics mixed into animal feed written in Law No. 18 of 2009 on Animal Husbandry and Health which is then clarified by the Minister of Agriculture Regulation No. 14/Permentan/PK.350/5/2017 on the Classification of Animal Drugs. The purpose of this study is to determine the factors which influence the formation of policy on the prohibition of hormone and antibiotic use as feed additives, especially health, legal, political and economic factors. This research uses descriptive study by qualitative approach. Data were collected using in-depth interviews and literature studies. The result shows that legal factors have a stronger influence than health, economic and political factors. The study recommends that the government should develop monitoring programs, conduct surveillance in feed and breeder entrepreneurs, establish good coordination with local governments, conduct further residue studies on animal source food, and further review the economic impact of the policy. Breeders also need to improve the cleanliness of the cage and try natural feed. While feed entrepreneurs need to find a replacement of antibiotic/hormone mixed feed safely

Analisis Jumlah Kebutuhan Tenaga Pekarya Dengan Work Sampling Di Unit Layanan Gizi Pelayanan Kesehatan = Analysis of the Optimal Number of Support Staff Needed Using Work Sampling in the Nutritional Services Unit

Backgrounds: The most important components in the hospital services are human resources. Professional management is needed to determine the type as well as the quality of the human resources to assure the quality productive hospital services. This study aimed at finding out of the optimal number of support staff needed in The Nutritional Services Unit at SI. Carolus Health Services 2005 Methods: This was a time motion study with work sampling method. Samples were all workers (13 people) in The Nutritional Services Unit. Data were collected through observation of worker activities in The Nutritional Services Unit in 7 consecutive days (9-15 June 2005). The data were analyzed using Workload Indicators of Staffing Need (WISN) method. Results: The analysis showed that using productive time of the activities time total in one working shift is 53.36% and using productive time of working hours is 43,57%. 24,93% is used for direct activities in morning working hours and 17.94% is used for direct activities in afternoon working hours. II was concluded that the productive use of the support was still very low. Based on the use of the productive working hours, eight people of support staff are needed, and based on the WISN method, only seven people of support staff are needed. Conclusions: The optimal number of support staff needed in The Nutritional Services Unit at St. Carolus Health Services is seven people. This means that there are an excessive number of support staff i.e. six people. Keywords: workload, work sampling Latar Belakang: Sumber daya manusia merupakan salah satu komponen penting dalam pelayanan rumah sakit. Manajemen profesional sangat dibutuhkan untuk menentukan kualitas sumber days manusia dalam memberikan pelayanan rumah sakit yang berkualitas. Penelitian bertujuan untuk mengetahui jumlah optimal kebutuhan tenaga pekarya di Unit Layanan Gizi Pelayanan Kesehatan Sint Carolus tahun 2005. Metode: Penelitian ini merupakan penelitian kuantitalif dengan menggunakan metode work sampling. Samoal penelitian adalah seluruh pekerja (13 orang) di Unit Layanan Gizi Pelayanan Kesehatan Sint Carolus. Pengumpulan data dilakukan melalui pengamatan terhadap kegiatan pekerja di Unit Layanan Gizi Pelayanan Kesehatan Sint Carolus selama 7 hari berturut-turut (9-15 Juni 2005). Data dianalisis dengan menggunakan metode Workload Indicators of Staffing Need (WISN). Hasil: Hasil analisis menunjukkan bahwa produktifitas atau penggunaan waktu produktif terhadap waktu kerja dalam satu shift kerja adalah 43,57 % dan penggunaan waktu produktif terhadap total waktu kegiatan dalam saw hari kerja 53,36 %. Kegiatan langsung tenaga pekarya di layanan gizi Pelayanan Kesehatan Sint Carolus pada waktu pagi hari 24.93%, sedangk an pada waktu kerja sore Iebih rendah sebesar 17,94%. Dapat disimpulkan bahwa penggunaan waktu produktif tenaga pekarya masih rendah. Berdasarkan penggunaan waktu produktif dibutuhkan 6 tenaga pekarya, dan berdasark an metode WISN hanya dibutuhkan 7 tenaga pekarya. Kesimpulan: Jumlah optimal kebutuhan tenaga pekarya yang dibutuhkan di Unit Layanan Gizi Pelayanan Kesehatan Sint Carolus sebanyak 7 orang tenaga pekarya. Hal ini menunjukkan adanya kelebihan jumlah tenaga pekarya Unit Layanan Gizi Pelayanan Kesehatan Sint Carolus sebanyak 6 orang. Kata Kuria beban kerja, work samplin

Analisis Perencanaan Obat Berdasarkan ABC Indeks Kritis di Instalasi Farmasi = Analysis of Drug Planning Based on ABC Critical Index in Pharmacy Unit.

Background: Planning process is one of the important functions in logistic management. This study aimed at finding out drug planning in Pharmacy Unit Karya Husada Hospital in Cikampek, Jawa Barat, using ABC Critical Index. Methods: This was a qualitative descriptive study, involving 10 informants. Primary data were collected using questionnaire and check list, and the secondary data were collected from pharmacy unit, finance division and logistic division. Results: By using ABC Critical Index showed that out of 1007 drug items, 36 (3,57%) are categorized as group A, 270 (26,81%) are categorized as Group B, and 701 (69,61%) are categorized as Group C. Conclusions: ABC Critical Index method helps out hospital effectively plan drug consumption by considering drug: 1) utilization, 2) investment value, and 3) critical status (vital, essential and non essential). The standard therapy is another important aspect in drug planning for doctors in prescribing therapy. Keywords: ABC critical index, pharmacy unit, standard therapy, hospital management Latar Belakang: Proses perencanaan merupakan salah satu fungsi yang panting dalam manajemen logistik. Penelitian ini bertujuan untuk mengetahui gambaran proses perencanaan obat di Instalasi Farmasi Rumah Sakit Karya Husada Cikampek Jawa Barat dengan menggunakan ABC Indeks Kritis. Metode: Penelitian merupakan penelitian deskriptif kualitatif dengan melibatkan 10 inforrnan. Data primer diperoleh melalui wawancara menggunakan kuesioner dan check list, sedangkan data sekunder diperoleh dari Instalasi Farmasi, Bagian Keuangan dan Bagian Logistik. Hasll: Dengan menggunakan ABC Indeks Kritis, hasil penelitian menunjukkan bahwa dari 1007 item obat, 36 item merupakan kelompok A (3,57%), 270 item obat dikelompokkan sebagai kelompok B (26,81%), dan 701 item obat merupakan kelompok C (69,61%). Keslmpulan: MetodeABC Indeks Kritis dapat membantu rumah sakit dalam merencanakan pemakaian obat dengan mempertimbangkan : 1) utilisasi, 2) nilai investasi, 3) kekritisan obat (vital, esensial dan non esensial), Standar terapi merupakan aspek panting lain dalam perencanaan obat karena akan menjadi acuan dokter dalam memberikan terapinya. Kata kunci :ABC indeks kritis, instalasi farmasi, standar terapi, manajemen rumah saki

Computerized Physician Order Entry (CPOE) in Reducing Medication Error: A Narrative Review

ABSTRACT Medication error leads to death and injury every day, causing lower quality of life and spend almost 1% of total global health expenditure. One of the solution of to prescribing error is using technology such as Computer Physician Order Entry (CPOE). This study purpose is to assess the use of CPOE in reducing medication error. The research method is a review of the narrative literature using systematic research, with 14 included studies. CPOE systems in hospitals were found to be capable of reducing medication errors especially in prescribing and administrative stage. However, CPOE system can be associated with new types of medication error, therefore, CPOE system must considered human factor, tailored according to the need of the hospital, and continuous training to reduce medication error

AN ANALYSIS ON THE POLICY IMPLEMENTATION OF ANTIBACTERIAL RESISTANCE CONTROL AT THE HOSPITAL

Abstract. In order to control Antibacterial Resistance at the hospital in Indonesia, the Government of Indonesia established an Antibiotics Resistance Control Committee and issued a Regulation from the Ministry of Health, regulation no 8/2015 on an antibiotics resistance control program at the hospital. This is an investigation on the Antibacterial Resistance Control Program (ARCP) at the Hospital, which compares its implementation at a government hospital and a private hospital, Persahabatan Central General Hospital (CGH) and Bogor Indonesian Red Cross Hospital (BIRCH). This was a descriptive study with a qualitative analysis obtained through indepth interviews and documentary research. We discovered that the ARCP was implemented better at Persahabatan CGH compared to BIRCH. Problems include ineffective communication, limited resources, lack of an antibiotic guideline (at BIRCH), lack of coordination between organizations, lack of supervision from the government, and the lack of motivation to implement the policy. These issues can be solved by intensifying the socialization of the policy, conducting more workshops and trainings for private and government hospitals that has not received any, providing an incentive for them to implement the program, such as including ARC into hospital accreditation indicators, and clarifying the benefits of the program to the stakeholders. Abstrak. Salah satu upaya pengendalian resistensi antibiotika di Indonesia adalah pembentukan pembentukan Komite Pengendalian Resisten Antibiotika (KPRA) dan diterbitkannya Permenkes no. 8 Tahun 2015 tentang program pengendalian resistensi antibiotika (PPRA) di rumah sakit (RS). Penelitian ini bertujuan untuk menggali lebih dalam terhadap implementasi kebijakan PPRA di RS dibandingkan antara RS pemerintah dengan RS swasta yaitu RS Persahabatan dan RS PMI. Metode penelitian merupakan studi deskriptif dengan analisis kualitatif melalui wawancara mendalam dan telaah dokumen. Hasil penelitian menyimpulkan bahwa pelaksanaan PPRA di RS Pemerintah lebih baik dari RS Swasta. Saran yang diajukan adalah mempercepat peningkatan kesadaran akan pentingnya PPRA, terutama bagi RS

Hospital Readiness for Covid 19 Pandemic in Bekasi District Hospital

Background: In the beginning of Covid-19 pandemic, most of hospitals were unplanned to handle this pandemic. The purpose of this study’s are to analyze the hospital readiness to cope with pandemic circumstances by evaluating hospital strategies as well as action which implement by the hospital.  Methods: The study employs a method approach that includes both mix quantitative and qualitative methods. Quantitative design use main data while score and percentage as an outcome of response from checklist based on WHO Rapid Hospital Readiness as a quantitative study supported with qualitative study by in-depth interview utilize response from 12 different components on the checklist. Measurement of Hospital Readiness was carried out in Bekasi District Hospital and responses were obtained three times within seven months duration. Results: The results are as follows, first period as a baseline data in December 2020, the average score assessed is 69%, second period were taken on April 2021 average score slightly improve to 81% and the last period in July 2021 result increased to 90%.  In the last period among other component, Component 10 have the lowest percentages (60%). By accomplishing the strategy for each period and continuously evaluated, the score or percentage by assessment of surge capacity readiness due to the Covid-19 pandemic has increased in Bekasi District Hospital, indicating the hospital is more ready to deal with surge capacity, and hospital perseverance is good enough. Conclusion: The checklist of the hospital readiness can be used as a baseline and a tool for hospital and health facilities evaluation

Rancangan Pola Karir Perawat Klinik Di Rumah Sakit Tentara Jakarta

Clinical Nurse in an army hospital has unique career & development pattern. This study aimed at finding out description on an effective career pattern for clinical nurses at army hospital. This was a qualitative study conducted from March-April 2006 involving 25 informants. Primary data was collected by in-depth interview and secondary data was collected from documentations related to policy and regulation in career development of clinical nurse. The data source was from the hospital and its governing institutions; i.e. Regional Army Office & Ministry of Defense & Security. The results showed there was unclear development pattern for clinical nurses in army hospital. Different status of the nurse in the hospital has different characteristic of development. Almost all of training programs at the hospital are directed by the governing institutions with little involvement from the hospital management. Working experience, as part of career development, is mostly achieved due to experience in the organization, military rank (army), employment grade (government official), rotation and promotion programs, education and training, and military field duty. The policy and regulation on career development of clinical nurses depend on the policy & decision of the governing institutions. This research develops career development patterns for all clinical nurses based on their status, clinical duty, and structural assignment. The career pattern developed is appropriate with nurse's education, work experience, and its competence

Analisis Pengaruh Dimensi Fraud Triangle Dalam Kebijakan Pencegahan Fraud Terhadap Program Jaminan Kesehatan Nasional di RSUP Nasional Cipto Mangunkusumo

AbstrakJaminan Kesehatan Nasional (JKN) yang diselenggarakan oleh Badan Jaminan Sosial (BPJS) Kesehatan telah mulai dilaksanakan dari 1 Program Asuransi Kesehatan di Indonesia Januari 2014. Pelaksanaan program asuransi nasional menemukan risiko. Risiko kejadian fraud (kecurangan) di Indonesia sangat tinggi. Namun,risiko kejadian fraud masih sulit untuk diidentifikasi. Hal tersebut didukung oleh kurangnya kesadaran semua pihak baik dari pasien, provider dan perusahaan asuransi walaupun tindakan tersebut sangat terasa adanya. Penipuan kesehatan merupakan ancaman serius bagi seluruh dunia, yang menyebabkan penyalahgunaan keuangan sumber daya yang langka dan dampak negatif pada akses kesehatan, infrastruktur,dan determinan sosial kesehatan. Penipuan kesehatan dikaitkan dengan meningkatnya biaya kesehatan yang terjadi di Amerika Serikat. Penelitian ini untuk menganalisis tentang pengaruh dimensi fraud triangle dalam kebijakan pencegahan fraud terhadap program Jaminan Kesehatan Nasional yang merupakan alasan untuk penipuan kesehatan. Penelitian ini menggunakan pendekatan kualitatif. Teknik pengumpulan data berupa pedoman wawancara, alat perekam, arsip tertulis dan dokumen. Hasil penelitian mendapatkan analisis tekanan, kesempatan, dan rasionalisasi terhadap risiko kejadian fraud dan menyajikan contoh bagaimana kebijakan telah berdampak di RSUP Nasional DR Cipto Mangunkusumo. Tesis ini kemudian akan memberikan saran tentang bagaimana mencegah penipuan kesehatan masa depan untuk mengurangi pengeluaran kesehatan dan penggunaan sumber daya untuk kepentingan RSUP Nasional DR Cipto Mangunkusumo.AbstractThe National Health Insurance (JKN) held by the Social Security Agency (BPJS) Health started to be implemented from 1 Indonesia’s Health Insurance Program in January 2014. The implementation of a national insurance program found the risk. The risk of occurrence of fraud in Indonesia is very high but it is still difficult to identify its risk. This is supported by the lack of awareness of all parties, including patients, providers and insurance companies although such actions exists. Health fraud is a serious threat to the entire world, which led to financial abuse of scarce resources and the negative impact on access to health care, infrastructure, and social determinants of health. Health fraud is associated with increased health care costs in the United States. This study was to analyze the influence of the dimensions of the fraud triangle in fraud prevention policies towards the National Health Insurance program which is the reason for health fraud. This study used a qualitative approach. Data collection techniques such as interview guides, recorders, written records and documents. The study reported stress analysis, opportunity, and rationalization of the risk of fraud incident and presents examples of how policy has an impact on the National Hospital Dr. Cipto Mangunkusumo. This thesis will then provide advice on how to prevent future fraudulent health to reduce health spending and use of resources for the benefit of the National Hospital Dr. Cipto Mangunkusumo

An Analysis of the Factors that Influence the Implementation of the Policy for Monitoring Schoolchildren Meals Monitoring at Batam City

Schoolchildren are assets for the development of the nation. Therefore, healthy meals at schools are very important, because for them, it covers about 25-36% of the daily energy requirements. Unhealthy eating habits or consumption of nutrition deficient meals may cause stunting, cardiovascular diseases, cancer, diabetes, and osteoporosis. In the short term it may also cause dental caries, anemia, overweight children and obesity. Around 40-44% of meals at schools do not satisfy the food safety requirements. To increase the quality of the meals at the schools, the community should be empowered to perform independent monitoring of school meals. This is inscribed in the national action policy for safe, good-quality, and nutritious meals for schoolchildren. The aim of this research was to assess the effectiveness of the implementation of the national action policy for the snacks of schoolchildren and the factors that influences it. This was a qualitative research. The data was gathered from in-depth interviews and documentary studies and then analyzed using the policy implementation analysis of Mazmanian and Sabatier. From this research we discovered that the policy did not perform effectively in Batam City. There were no  Procedure Standard Norms NSPK on the roles, tasks, and responsibilities of the implementers, there was no implementation structure, and no support from the Government and the Parliament of Batam City for the monitoring