PENGEMBANGAN TELEMEDICINE MELALUI PELAYANAN KLINIK VIRTUAL RS KARIADI DALAM PEMENUHAN HAK PASIEN DI ERA PANDEMI COVID

Pelayanan kesehatan melalui telemedicine pada masa pandemi Covid-19 seperti Klinik Virtual RS Kariadi merupakan pelayanan kesehatan jarak jauh berbasis teknologi untuk pemberian informasi kesehatan, diagnosis, pengobatan, pencegahan pemburukan, evaluasi kondisi kesehatan, dan/atau pelayanan kefarmasian kepada pasien. Penelitian ini bertujuan untuk mengetahui pengaturan tentang pemenuhan hak pasien, mengetahui penerapan pelayanan, dan mengetahui perlindungan hukum bagi pasien, dalam layanan telemedicine melalui klinik virtual RS Kariadi. Metode yang digunakan dalam penelitian ini adalah metode kualitatif dengan pendekatan yuridis sosiologis. Jenis data yang dikumpulkan meliputi data sekunder dan data primer yang diperoleh dari studi lapangan dan studi pustaka. Studi lapangan dilakukan dengan wawancara semi terstruktur melalui metode Focus Group Discussion (FGD) terhadap narasumber yaitu Dokter, Tenaga Kesehatan, Tenaga IT dan Pasien di RS Kariadi Semarang. Data disajikan bersifat deskriptif yaitu hasil wawancara beserta hasil analisis. Hasil penelitian menunjukkan bahwa pemenuhan hak pasien dalam telemedicine melalui pelayanan klinik virtual RS Kariadi belum terpenuhi dari prinsip aksesibilitas, kualitas dan kesetaraan, serta bertentangan dengan Pasal 5 ayat (1) UUD 1945, Pasal 5 Undang-Undang Nomor 36 Tahun 2009 tentang Kesehatan, dan Keputusan Menteri Kesehatan Nomor HK.01.07/MENKES/4829/2021 tentang Pedoman Pelayanan Kesehatan melalui Telemedicine Pada Masa Pandemi Covid-19. Dari sisi regulasi, penerapan pelayanan klinik virtual RS Kariadi berjalan dengan baik dan sesuai dengan perundang-undangan yang berlaku. Pasien telemedicine melalui klinik virtual RS Kariadi mendapatkan jaminan terjaganya kerahasiaan pasien, keamanan data pasien, perlindungan data rekam medis pasien, serta jaminan keabsahan dokter praktik yang memiliki SIP dan STR pada layanan klinik virtual RS Kariadi. Kata Kunci: Telemedicine, Pelayanan Klinik Virtual, Pemenuhan Hak Pasien, Perlindungan Hukum

IMPLEMENTATION PROCESS OF STRATEGIC PLANNING AT DISTRICT GENERAL HOSPITAL

Background: A strategic plan is the main reference for the management in carrying out activities to be better and more developed according to the customer’s needs. A preliminary study on documents was conducted at the District General Hospital of Dr. (H.C) Ir. Soekarno in Bangka Belitung Province which has implemented a strategic plan. It showed that there were gaps between expectation and implementation of strategic plan.Aim: This study aimed to analyze aspects affecting the strategic plan implementation, including communication, resources, disposition, and bureaucratic structure.Methods: This study was a descriptive study using a qualitative approach. Primary data were obtained through in-depth interview with 10 (ten) informants while secondary data were obtained from document analysis. The data processing and analysis were done using content analysis. The research was conducted from 2 to 31 January 2019 at the District General Hospital of Dr. (H.C) Ir. Soekarno.Results: The findings showed that the implementation process of strategic plans has some gaps. They include (1) ineffective communication, (2) resource factor (lack of quality and quantity of Human Resources, inadequate information, insufficient effectiveness of budget utilization), (3) weak disposition of some implementers, and (4) irrelevant and unadjusted bureaucratic structure.Conclusion: The implementation process of strategic plan has not worked appropriately because some aspects, such as communication, resources, disposition, and bureaucratic structure are not well-provided. This study suggests that formulators should represent all elements. The strategic planning has to be formulated by involving internal and external parties.  Monitoring, evaluation, communication, and coordination among stakeholders have to be carried out. Resources need to be improved, and the hospital needs to develop organization structure and conduct disposition guide for executives and implementors.Keywords: implementation, strategic plan, hospital.

Pengaruh Simvastatin terhadap Ketebalan Intima-Media Karotis pada Pasien Stroke Iskemik dengan Diabetes Mellitus Tipe 2

BACKGROUND :Ischemic stroke is the most common stroke comprising 70-80% of all cases. Carotid intima-media thickness (CIMT) is associated with the occurrence of stroke in older age and adults. Patients with type 2 diabetes mellitus tend to develop a thickening of intima-media carotid artery. Simvastatins inhibit further atherothrombotic process. OBJECTIVE : To analyze the effect of simvastatin for CIMT in ischemic stroke patient with type 2 diabetes mellitus. METHOD : This study was a Randomized Pretest-Posttest Design and conducted at the Hospital Inpatient Ward Dr. Kariadi and Ketileng Semarang from January to December 2014 for all first ischemic stroke patients with Type 2 Diabetes Mellitus. Subjects were divided into groups of 26 controls and 28 patients treated groups. Treatment group were given simvastatin 20 mg each daily for 24 weeks in 28 subjects with a history of acute ischemic stroke and type 2 Diabetes mellitus. Examine the CIMT at the 1st week and 24th week. The normality of the data were tested using Shapiro Wilk and the differences analyzed by using Paired t-test and independent t test. RESULT : There was a significant differences between delta carotid intima-media thickness on administration of simvastatin for ischemic stroke patients with type 2 diabetes mellitus (p=0,008). CONCLUSION : Simvastatin significantly decreases CIMT on ischemic stroke patients with type 2 diabetes mellitus. Keyword : simvastatin, ischemic stroke, carotid intima-media thickness, type 2 diabetes mellitus   LATAR BELAKANG :Stroke iskemik memiliki angka insidensi terbanyak yaitu 70-80% kasus stroke. Ketebalan Intima-media karotis berhubungan dengan terjadinyastroke pada usia tua.Pasien dengan Diabetes mellitus tipe 2 memiliki kemungkinan yang lebih besar mengalami penebalan intima-media carotis. Simvatatin menghambat proses aterotrombosis. TUJUAN :Untuk menganalisis pengaruh simvastatin terhadap ketebalan intima-media karotis pada pasien stroke iskemik dengan diabetes mellitus tipe 2. METODE :Penelitian ini adalah dengan Randomized Pretest-Posttest Design dan telah dilakukan di Rawat Jalan RSUP dr. Kariadi dan poli saraf rawat jalan RSUD Kota Semarang mulai Januari sampai dengan Desember 2014 untuk semua pasien stroke iskemik pertama kali dengan diabetes mellitus tipe 2. Subjek dibagi menjadi kelompok kontrol 26 pasien dan kelompok perlakuan 28 pasien. Kelompok perlakuan diberi simvastatin 20 mg sehari selama 24 minggu pada 28 subjek stroke iskemik dengan  diabetes mellitus tipe 2. Pemeriksaan ketebalan intima-media karotis dilakukan pada minggu ke-1 dan minggu ke-24. Data kemudian di uji normalitasnya menggunakan Saphiro wilk, lalu di analisis menggunakan uji beda paired t testdan independent t test. HASIL :  Kelompok perlakuan didapatkan penurunan ketebalan tunika intima arteri karotis (0,395 + 0,46; p=0,514), KESIMPULAN : Pemberian simvastatin menurunkan ketebalan intima-media karotis secara bermakna pada pasien stroke iskemik dengan diabetes mellitus tipe 2. Kata Kunci     :simvastatin,stroke iskemik, ketebalan intima-media karotis, diabetes mellitus tipe 2     &nbsp

Gaya Hidup yang Berpengaruh terhadap Kejadian Stroke Iskemik pada Usia Kurang dari 45 Tahun (Studi Pada BLUD RSUD Cut Nyak Dhien Meulaboh Kabupaten Aceh Barat Provinsi Aceh)

Background: Ischemic stroke that occurs at the age of less than 45 years accounts for about 5 until 10 percent of the total stroke. This is influenced by changes in the life-style of modern society, such as changes in the pattern of food consumption, lazy to move, and smoking habits. This study aims to examine the effect of life-style on ischemic stroke at less than 45 years old people.Method: This study uses observational method with design of cases and controls. The samples are 86 observations consisting of 43 cases and 43 controls. Cases are patients with ischemic stroke less than 45 years of age and controls are non-stroke patients of neurology who are less than 45 years old.Results: The results show that the habit of consuming food containing high fat (p=0,032, OR=3,744, 95% CI=1,124-12,468) and smoking habit (p=0,019, OR=3.859, 95% CI=1,250-11,911) affect the occurrence of ischemic stroke at age less than 45 years. However, the habit of consuming red meat, consuming foods containing high salt, consuming drugs, and lack of physical activity do not affect the occurrence of ischemic stroke at age less than 45 years.Conclusion: The habits of consuming food containing high fat and smoking affect theoccurrence of ischemic stroke at age less than 45 years after hypertension, heart disease, and diabetes mellitus are controlled

The Association Between Variants of Angiotensin Converting Enzyme (ACE) Gene with Risk Factors in Patients with Ischemic Stroke at Dr. Kariadi Semarang

BACKGROUND : Stroke is the leading cause of death and disability in the world. The occurrence of ischemic stroke is indicated by genetic factors, environmental factors and the interaction between it. Angiotensin Converting Enzyme (ACE) genetic variant is associated with various characteristics of risk factors for ischemic stroke. OBJECTIVE : Identifying genetic variants of Angiotensin Converting Enzyme (ACE) with the Polymerase Chain Reaction (PCR) method and to find it's correlation beetwen risk factor in patients with Ischemic Stroke at Dr. Kariadi Semarang METHOD : The subjects of the study were 72 patients with ishcemic stroke who were treated at the polyclinic of the Neurology Department Dr. Kariadi Semarang in January - December 2013. DNA extraction of research subjects was carried out at the Laboratory of the Center of Biomedical Research (CEBIOR), Faculty of Medicine, Diponegoro University from January to March 2020. Amplification using the Polymerase Chain Reaction (PCR) method was carried out using an Eppendorf thermocycler. Data were analyzed with SPSS for Windows Version 25 RESULT : 72 samples analyzed obtained genetic variants of ACE II 39 (54.2%) samples, genetic variants of ACE DI 30 samples (41.7%), and genetic variants of ACE DD 3 (4.2%) samples. Meanwhile, there was no significant relationship ( p>0,05 ) between genetic variants of ACE and the characteristics of risk factors for ischemic stroke, namely age, gender, Body Mass Index, smoking history, triglyceride levels, HDL levels, LDL levels, obesity and hypertension. CONCLUSION : There are three types of ACE genetic variants, including the ACE II genetic variant, the ACE DI genetic variant, and the ACE DD genetic variant. Among the three genetic variants, ACE II genetic variant is the most common variant and there is no significant relationship to the various risk factor characteristics found in ischemic stroke patients at Dr. Kariadi Gneeral Hospital Semarang