Pengembangan SDM Kesehatan di Era Desentralisasi dan Mekanisme Pasar

Political changes in health policy, pertaining to the regional autonomy in lndonesia, have caused changes in the structural and funetional components in the health field at Provincial and District level. The role of District Health Office becomes very essential in manage the health program and resources, including health human resources. Since the variability of resources between inter-regional health system is veryenormous, and same problems are existed, thus government should develop the system atie scenario of human resources management system. The scenario needs support from a leader that has visionary and transformationalleadership as well as entrepreneur and professionalism mindset to tackling the health problems in the regional area. In conclusion, despite the important role of District Health Office in managing the health human resources as the anticipation of the impact ofdecentralization, the health workers should also take the opportunities and challenge to provide program and health services that suffice the needs and demands of societ

Improving Performance of Nursing Documentation Based on Knowledge Management Through Seci Concept Model's

Introduction: Documentation of nursing care in Kalianget RSI in 2011 was totaled average 58,1% and in 2012 achieve was still low. According the lowest component was nursing diagnosis. This research aims to improve the performance of nursing care documentation based on knowledge management through the SECI Model's concept in Garam Kalianget RSI Sumenep District. Method: Design of this research was action research. Population and sample in the research of knowledge, motivation and work responsibility were all nurses total ed 29 people. The dependent variable were knowledge, performance, motivation, work responsibility, and performance after intervention knowledge management (KM) and as independent variable in this research was knowledge, performance, and intervention research knowledge management in documentation nursing care. Data were collected by using questionnaires and checklists. Result: The results after the SECI model's intervention and using Paired t Test with a 95% confidence level of knowledge obtained p = 0.0001 which means that there was a significant knowledge difference between before and after intervention, comparison of performance documenting of nursing care obtained value ρ = 0.004, which means there was a difference significant performance between before and after intervention. Comparison of SBAR effective communication performance values obtained ρ = 0.001, which means there was a significant performance difference between before and after intervention. Discussion: Knowledge management through SECI model's has important role in improving performance documentation of nursing care and SBAR effective communication. It is recommended to do in forum sharing nurse's experience or informant in practical communication in periodic, recording, documentation, and keep document well and doing supervision continously especially form nursing care and SBAR effective communication

Objective Workload of Nurses in the Inpatient Services at the Hospital

Inpatient services at the X Hospital consists of Intensive Care Units and Inpatient Units. In 2014, a nurse at the unit as a whole experienced a shortfall of 66.67% from 9 rooms there. This shortage triggered theincreasing of nurse workload. This study aimed to find out the objective workload on nurses in Intensive Care Units and Inpatient Units. This research is quantitative descriptive with cross-sectional design. The sample used is total sampling, as many as 174 nurses. Data obtained using activity sheets time and motion study indirectly (self-assessment). Results from this study show the objective workload in the Intensive Care Unit on the morningshift have a heavy workload category, afternoon shift and the night shift has a moderate workload category, while at Inpatient Unit on the morning shift and afternoon shift has a heavy workload category, and shift night has amoderate workload category. The conclusion of this study is objective workload in the Intensive Care Unit has a moderate workload category, while the objective workload in the Inpatient Unit has a heavy workload category

CHANGES IN ERECTILE FUNCTION BEFORE AND AFTER PROSTATE BIOPSY

Objective: To evaluate erectile function before and after transrectal ultrasound (TRUS) guided prostate biopsy using International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS) instrument. Material & Method: We conducted a study on 17 BPH LUTS patients who underwent TRUS guided prostate biopsy from January to April 2011 in Urological Minimal Invasive Installation (IIU) Dr. Soetomo Hospital. Out of 17 patients, three patients had mild ED, while 14 other patients had normal erectile function before the procedure. After TRUS guided prostate biopsy, we performed erectile function assessment using the IIEF-5 and EHS at weeks I, II, and IV. Results: Pathological examination of all specimens from prostate biopsy results revealed BPH. There were 2 patients with hematuria and 1 patient with rectal bleeding shortly after the biopsy, which resolved spontaneously less than 24 hours. Based on the IIEF-5 there were 4 patients (23,5%) with decreased erectile function in the evaluation of first week after prostate biopsy, and it reduced to 2 patients (11,7%) whose erectile function was still decreasing in the evaluation week II, while in fourth week evaluation there was 1 patient (5,9%) with decreased erectile function. Based on EHS data obtained, there were 5 patients (29,4%) with decreased scores in evaluations week II, and in the evaluation of week IV there were no patients having erectile function problems compared with EHS data before prostate biopsy. Conclusion: TRUS guided prostate biopsy can have temporary effect on erectile function.Keywords: Erectile dysfunction, prostate biopsy, international index of erectile function-5, erection hardness score

Stone-Free Rate Differences in Kidney Stones Patients With and Without Tamsulosin After ESWL

Objective: To determine whether the administration of tamsulosin, as adjunctive medical therapy, increases the efficacy of one session of extracorporeal shock wave lithotripsy (ESWL) to treat renal stones. Material & Method: A prospective randomized placebo controlled study enrolled 21 patients. They underwent a single ESWL session to treat solitary radiopaque renal stones 4 to 20 mm in diameter. After ESWL, the study group (11) received 0,4 mg tamsulosin daily and the control group (10) received placebo until stone clearance or a maximum period of 8 weeks. The primary endpoint was stone-free rate and parameters were stone size and clearance time. Results: The overall stone-free rate was better in the study group than in the control group (90,9% vs. 60,0%). The clearance time after 2, 4, 6 and 8 weeks was greater in the study group than in the control group (36,4%; 63,6%; 72,7% and 90,9% vs 30,0%; 50,0%; and 60,0% respectively) but statistically insignificant. Conclusion: Clinically, the results of our study have demonstrated that tamsulosin therapy, as an adjunctive medical therapy after ESWL, is more effective than lithotripsy alone for the treatment of patients with renal stones

Beban Kerja Obyektif Tenaga Perawat di Pelayanan Rawat Inap Rumah Sakit

Inpatient services at the X Hospital consists of Intensive Care Units and Inpatient Units. In 2014, a nurse  at the unit as a whole experienced a shortfall of 66.67% from 9 rooms there. This shortage triggered the increasing of nurse workload. This study aimed to find out the objective workload on nurses in Intensive Care Units and Inpatient Units. This research is quantitative descriptive with cross-sectional design. The sample used is total sampling, as many as 174 nurses. Data obtained using activity sheets time and motion study indirectly (self-assessment). Results from this study show the objective workload in the Intensive Care Unit on the morning shift have a heavy workload category, afternoon shift and the night shift has a moderate workload category, while at Inpatient Unit on the morning shift and afternoon shift has a heavy workload category, and shift night has a moderate workload category. The conclusion of this study is objective workload in the Intensive Care Unit has a moderate workload category, while the objective workload in the Inpatient Unit has a heavy workload category. Keywords: nurse,objective workload, time and motion stud

An analysis of individual and performance factor relation on Public Hospital Employee

Hospital is an organization that work on society service. One of efforts to supply optimal service is giving otority or autonomy on hospital. Giving autonomy on hospital conducting to change the status of hospital into BLUD (Badan Layanan Umum Daerah) or Regional Public Service Agency (RPSA). RPSA is a work unit of region equipment that created with a purpose to give society service by supply things or service which is sold without looking for profit and the activity is based on efficiency principal and productivity. Then this research is to find out on several individual factors, there are social, emotional and physical employee is affecting their performance individually or in groups and also the relationships between all these factors respectively. This research is used cross sectional design. The sample of this research is the 32 employe of hospital which is have RPSA label, that is located on Sampang Regional Public Hospital (RSUD). The variable measured based on EWPS (Endicott Work Productivity Scale) individual factor, that is social factor, emotional and physic. The result of this statistical test is used Spearman test which is work for knowing the relation between individual factor and individual performance. Statistic analyze show that social factor (rsp = 0.649), emotional factor (rsp = 0.795), physic factor (rsp = 0.962) is related with individual performance. © Medwell Journals, 2018

Knowledge on Breastfeeding and Breastfeeding Behavior among Working Mothers and Housewives : A Cohort Study

Background : Surabaya is one of the cities with low coverage of exclusive breastfeeding in East Java. The average rate of babies who got exclusive breastfeeding in Surabaya from 2012 to 2015 was 63.13% (target 80%). Decision about whether to breastfeed or not is a challenge for every mother, especially for working mothers. This research aimed to identify breastfeeding behavior among working mothers and housewives.Methods : This was descriptive observational research with prospective cohort study design.The sample size was 79 mothers in the eastern part of Surabaya chosen by purposive sampling technique.Results : Result showed that 56.6% of housewives have low knowledge on breastfeeding. Both working mothers (100%) and housewives (90.6%) already give colostrum right after baby born. However, There were 54.7% of housewives and 46.2% of working mothers already give formula milk during the first month after baby born.Conclusion : There were not much difference between working mothers and housewives in knowledge, feeding colostrum and skin to skin contact aspects. But, working mothers mostly give formula milk during the first month of baby born than housewives