Kepuasan Orangtua Pasien Terhadap Pelayanan di Bangsal Anak Sebagai Salah Satu Indikator Keberhasilan Pelayanan RSUP Sanglah di Denpasar

Abstrak Peningkatan permintaan pelayanan kesehatan di seluruh Indonesia menuntut rumah sakit pemerintah berbenah untuk mampu memberikan pelayanan terbaik pada masyarakat termasuk di RSUP Sanglah Denpasar, Bali. Penelitian ini bertujuan untuk mengetahui tingkat kepuasan orangtua pasien BPJS terhadap pelayanan di bangsal anak RSUP Sanglah Denpasar. Penelitian ini merupakan penelitian deskriptif analitik dengan pengambilan data dilakukan dengan cara menyebar kuesioner dengan metode SERVQUAL. Model SERVQUAL yang digunakan terdiri dari lima dimensi yaitu: 1) Tangibles, 2) Reliability, 3) Responsiveness, 4) Assurance, dan 5) Empathy. Kuesioner telah melewati uji reliabilitas dan vailiditas. Penelitian ini mengambil sampel secara consecutive sampling yaitu salah satu orangtua dari seluruh pasien anak yang dirawat di Ruang Cempaka 3 pada bulan April sampai September 2020. Analisis gap dan kuadran menggunakan analisis Importance Performance Analysis dengan diagram Cartesian. Dari 151 sampel yang terkumpul, didapatkan perbandingan lelaki banding perempuan 1,25:1. Rata-rata usia pasien adalah 5,75 tahun dengan rata-rata lama perawatan 8,8 hari. Berdasarkan analisis Importance Performance, tidak ada satupun atribut dengan nilai kenyataan lebih tinggi daripada harapan. Dimensi SERVQUAL dengan jumlah gap tertinggi adalah Reliability/keandalan. Pada analisis kuadran didapatkan bahwa seluruh dimensi kecuali dimensi tangibles (nyata) perlu meningkatkan performa. Secara umum, orangtua pasien belum puas terhadap pelayanan di RSUP Sanglah Denpasar khususnya di bangsal Cempaka 3. Kata kunci: kepuasan pasien, pelayanan rumah sakit, pediatri, SERVQUAL Abstract Increasing demand of health care in Indonesia require government hospital to compete in giving the best care. The objective of this study is to determine satisfaction level of BPJS patient parents in Sanglah General Hospital Denpasar. This is an analytical descriptive study using valid and reliable SERVQUAL questionnaire to collect samples. SERVQUAL model consists of 5 dimensions: 1) tangibles, 2) reliability, 3) responsiveness, 4) assurance, and 5) empathy. The questionnaire passed reliability and validity test. Samples were parents of all children admitted to Cempaka 3 Ward from April to September 2020 and were taken consecutively. Gap and quadrant analysis using Importance Performance Analysis and Cartesian Diagram were done. From 151 collected samples, the ratio of boys and girls were 1.25:1. Mean age of samples was 5.75 years old and mean hospital stay was 8.8 days. Based on Importance Performance Analysis, all of the reality value fell below expectation value. SERVQUAL dimension with the highest gap was reliability. In quadrant analysis, all of the dimensions except tangible need improvement. In general, parents of patients was not satisfied with health care in Cempaka 3 ward, Sanglah General Hospital Denpasar. Keywords: patient satisfaction, hospital care, paediatrics, SERVQUA

Correlation of Capute Scores with CD4 Count among Human Immunodeficiency Virus-infected Children in Sanglah Hospital, Bali, Indonesia

BACKGROUND: Cognitive, motoric, and language development in a human immunodeficiency virus (HIV)-infected child is an important issue that affects developmental milestone and quality of life. The effect of HIV infection on cognitive function must be detected early to prevent delayed cognitive, motoric, and language function. AIM: This study aimed to assess the correlation of cognitive scores with CD4 count among HIV-infected children in pediatrics polyclinic Sanglah Hospital, Bali. METHODS: This cross-sectional study recruited 68 HIV-infected children age 0–36 months old as participants. Cognitive score was assessed using Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) scores and HIV status, and CD4 count was obtained from the medical record. RESULTS: The result showed that mean of CD4 count among subject was 29.85 cells/mm3, there was positive correlation between CAT scores with CD4 count (r = 0.33, p = 0.006) and also between CLAMS scores with CD4 count (r = 0.307, p = 0.01). CONCLUSION: It can be concluded that CD4 count correlated with Capute scores on HIV-infected children

Correlation between Serum Level of Matrix Metalloproteinase-2 with Left Ventricular End-diastolic Volume in Children with Heart Failure

BACKGROUND: Left ventricular end-diastolic volume (LVEDV) on echocardiography is one of the tests performed on heart failure. This refers to the volume of the left ventricle at the end of the diastolic phase, which would be increased when there is a disturbance in preload, afterload, and contractility factors. Matrix metalloproteinase-2 (MMP2) is a marker of congestive heart failure that can be examined through laboratory examinations. AIM: The objective of the study was to provide evidence of the association between MMP and inflammatory process as well as its correlation with LVEDV in children with heart failure. METHODS: This was a cross-sectional study conducted on children aged 3 months–12 years old with heart failure, who visited Sanglah Hospital, Denpasar, Indonesia from May 2017 to March 2018. Echocardiographic examination (LVEDV) and blood samples were taken to measure the serum level of MMP2 on day 1 after the subjects were diagnosed with heart failure. RESULTS: A total of 32 subjects with heart failure were analyzed in this study. Acyanotic congenital heart defect (CHD) was the most common cause of heart failure, as observed in 23 subjects (71.9%). Characteristics data revealed that 24 subjects (75%) were underweight, 23 (71.9%) had cardiomegaly, and 22 (68.8%) had mild heart failure. Data analysis showed a moderate positive correlation between MMP2 levels with LVEDV after controlling for the influence of age (p = 0.02; r = 0.425). CONCLUSION: There was a moderate positive correlation between MMP2 level and LVEDV after controlling for the age factor

Faktor Risiko dan Luaran Fungsi Hati pada Asfiksia Neonatus di Unit Perawatan Intensif Neonatus (UPIN) RSUP Sanglah Denpasar

Latar belakang. Asfiksia neonatus menyebabkan disfungsi organ, termasuk hati sebagai salah satu organ yang dikorbankan akan mengalami cedera karena proses asfiksia. Tujuan. Mengetahui dan membandingkan luaran fungsi hati pada asfiksia neonatus dan mengetahui faktor risiko kejadian asfiksia. Metode. Penelitian dengan rancangan potong lintang, subyek dipilih dengan cara non random sampling, yaitu consecutive sampling, sejak bulan Juni sampai Desember 2010. Subyek penelitian 46 neonatus asfiksia dan 60 kontrol. Hubungan antara derajat asfiksia dengan parameter fungsi hati dilakukan dengan analisis of varian (ANOVA). Hasil. Dari 46 neonatus asfiksia, derajat ringan 21 (19,8%), derajat sedang 11 (10,4%), derajat berat 14 (13,2%). Terdapat perbedaan yang signifikan antara kelompok asfiksia dengan kontrol terhadap enzim serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), Prothrombin time (PT) dan International normalised ratio (INR)(p<0,001). Faktor risiko terhadap kejadian asfiksia adalah umur kehamilan (p<0,013) dan berat badan lahir (p<0,001). Kesimpulan.Asfiksia neonatus menyebabkan luaran SGOT, SGPT lebih tinggi dibandingkan kontrol. Nilai INR dan PT juga dipengaruhi oleh asfiksia neonatus

Luaran Bayi Kurang Bulan Late Preterm

Latar belakang. Bayi kurang bulan (BKB) mempunyai risiko tinggi terhadap penyakit-penyakit yang berhubungan dengan prematuritas. Kejadian BKB late pretermadalah 75% dari kelahiran BKB. Tujuan. Mengetahui dan membandingkan luaran lama rawat, kesakitan dan kematian BKB late preterm dengan bayi cukup bulan (BCB). Metode. Penelitian kohort prospektif, subyek faktor risiko adalah BKB late pretermdan BCB sebagai kontrol, yang lahir di RSUP Sanglah Denpasar mulai Januari 2010 sampai Desember 2010. Perhitungan analisis untuk mencari hubungan antara faktor risiko BKB late preterm dengan lama rawat, kejadian kesakitan dan kematian, dilakukan analisis multivariat dengan regresi logistik dan chi square. Hasil. Didapatkan perbedaan bermakna di antara kedua kelompok mengenai lama rawat <3 hari (p=0,027; RR=2,76; IK 95%,12-6,15), kesakitan (p=0,016; RR= 3,84; IK 95% 2,06-8,49) kematian (p=0,001; RR=6,6; IK 95% 1,46-9,37). Kesimpulan.Bayi kurang bulan late preterm memiliki risiko lebih tinggi menjalani waktu perawatan di rumah sakit, kejadian kesakitan, dan kematian dibandingkan BCB

Risk factors for hearing loss in neonates

Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects) and without hearing loss (control group of 50 subjects). The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040). There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates

Characteristics of referral neonates in Sanglah Hospital: reviewed from the S.T.A.B.L.E program

The purpose of this study was to investigate the number of referral neonates that came with an unstable condition (according to a S.T.A.B.L.E program) and characteristic of unstable conditions of the referred neonates. An observational prospective study was conducted for two years from 1st January 2018 to 31st December 2019 in the Emergency Department of Sanglah Hospital, Bali, Indonesia. Referred neonates were assessed in terms of gender, gestational age, referral characteristic, and condition on arrival at the hospital according to S.T.A.B.L.E criteria. According to S.T.A.B.L.E criteria, 283 neonates (54.8%) came on unstable condition. Prematurity (42.6%) was the main reason for referral, 37.9% of them were very low birth weight. Most of them were referred from Denpasar (33.9%), the equipment of transportation was incubator transport (41.8%). T-piece resuscitator was used in 30.4% of referred neonates. Characteristics of unstable conditions were mostly hypoglycemia (33%) and 36% of unstable neonates had more than one condition of instability. This study revealed 283 neonates were unstable and the main reason of transfer neonates is prematurity. Most of them come with unstable conditions that could lead to higher mortality. This study could be a reference for improvement in the neonatal transportation system in Bali

Nutritional status of preterm neonates at discharge in sanglah hospital

The purpose of this study was to determine the nutritional status of preterm neonates when discharged from the hospital. A descriptive study was reviewed from the register of preterm neonate after hospitalization in neonatal ward Sanglah Hospital Denpasar. The number of total samples in this study was 190 patients. Most of the preterm neonates in this study were low birth weight (59.47%). At the beginning of the hospitalization, there were 83.86% preterm neonates with good nutritional status, decreased to 54.73% at discharge from the hospital. The group of neonates that had the highest number of decreases in the good nutritional status at discharge was found in 28-32 weeks gestational age. Most of the samples used breast milk for enteral feeding (68,42%). In preterm neonates with sepsis, only 42.52% neonates discharge with good nutritional status. Low birth weight preterm neonates with kangaroo method care were found increased weight gain in 78.57% neonates. The nutritional status of preterm neonates following hospitalization at Sanglah hospital is still not good. The preterm neonates with good nutritional status were decreased at discharge from the hospital

PROCEEDING SEMINAR NASIONAL: SENI RUPA NUSANTARA BASIS KEUNGGULAN NASIONAL TAHUN 2016

Om Swastiastu, Seminar Nasional pada tanggal 28 Oktober 2016, diselenggarakan oleh Fakultas Seni Rupa dan Desain (FSRD), Institut Seni Indonesia (ISI) Denpasar dan diikuti oleh 17 pemakalah inti dan artikel pendamping yang dihimpun dalam buku Procceding Seminar Nasional 2016: “Seni Rupa Nusantara Basis Keunggulan Indonesia”. Makalah Seminar Nasional ini call for pa- per, sangat berarti bagi FSRD-ISI Denpasar dalam bentuk procceding yang ber ISBN 978-602- 9855-8-3. Seminar nasional ini juga menghadirkan keynote speaker Wali Kota Denpasar, I.B Rai Dharmawijaya Mantra, Pembicara sesi (I) Prof. Dr. Agus Burhan (Rektor ISI Yogyakarta), Pembicara sesi (II) Dr. Dody Wyancoko (Dosen ITB Bandung), dan Pembicara sesi (III) Dr. I Wayan Kun Adnyana ISI Denpasar. Seminar nasional akan diarahkan untuk mengembangkan “cara berpikir” dari berbagai aspek dalam studi seni rupa dan desain, termasuk media rekam untuk penciptaan suatu karya. Panitia penyelenggara mewakili institusi FSRD-ISI Denpasar yang menjadi tuan rumah seminar nasional, mengucapkan banyak terima kasih atas partisi- pasi para akademisi dan para pemerhati seni rupa Indonesia seperti: Seni Lukis, Seni Patung, Produk Kriya, Desain Interior, Desain Komunikasi Visual, Fotografi, Desain Mode, Film dan Televisi kemudian mempresentasikan dalam seminar nasional ini. Adapun bentuk sub tema: 1). Eksplorasi Seni Rupa Nusantara; 2). Keragaman Seni Rupa Nusantara, 3). Peluang studi dan penelitian; 4). Konsep dan filosofi Seni Rupa Nusantara. Dengan kerendahan hati panitia men- gucapkan selamat berseminar, terutama kepada peserta utusan dari; Universitas Negeri Malang (UNM), Institut Teknologi Bandung (ITB), Universitas Padjadjaran (UNPAD) Bandung, Uni- versitas Negeri Yogyakarta (UNY), Universita Mahasaraswati (UNMAS) Denpasar, Universitas Bunda Mulia Jakarta, dan Institut Seni Indonesia (ISI) Denpasar. Dengan penuh harapan, bahwa kegiatan seminar nasional ini dapat terselenggara den- gan sukses membawa pengalaman baru serta persahabatan abadi. Atas nama panitia, tidak lupa kami mengucapkan mohon maaf apabila ada pelayanan yang kurang memuaskan dan mungkin dilain waktu bisa lebih baik lagi penyelenggaraannya. Salam seni dan budaya. Om Santih Santih Santih O