The Childbirth Services Aspect That Influence Patient Satisfaction

Pregnant women have higher expectations of the care providers attitude in order to have childbirth satisfaction. This study aims to analyze the relationship between childbirth services and birth satisfaction in Roemani Muhammadiyah Semarang hospital. We used a cross sectional design and used an interview to collect the data, it was conducted from July to August 2016. A total of 79 women were enrolled in the study that fulfill the inclusion and exclusion criteria. The childbirth services and patient satisfaction were measured using survey instruments which we'd measured the reliability and validity previously. The linier regression were applied. The majority of the patients (94,9%) were 21-40 years old, 67,1% were university graduate, 40,5% were housewife, 62% were multigravida, and 57% were delivered by cesarean section. There were significant effect between interpersonal relationship (p=0,0001), patient decision choice (p=0,001), and breastfeeding management (p=0,021) and birth satisfaction. The strongest predictor of birth satisfaction was interpersonal relationship

Deteksi Dini Derajat Kesadaran Menggunakan Pengukuran Nilai Kritis Mean Artery Pressure

Introduction: The Impact of the trauma cranio cerebral can affect the volume autoregulation disorders any intracranial disease that consists of the brain and cerebrospinal fluid and the blood in the veins. The changes one of the volume without followed the response of compensation from the other factors will cause overt increased intracranial pressure changes and the amount of blood flow from the systemic circulation required to give oxygen and glucose intake to the metabolism of the brain. One of the things that is very important in nursing nursery on patients with injury head is to maintain the adequacy of Mean Artery Pressure cerebral. This research aims to know the adequacy of critical value mean artery pressure in detecting the level of consciousness in patients who suffered injury on the head. Method: This research using explanatory design research with cross sectional approach that explains the influence and the prediction of the adequacy of the critical value mean arteria pressure against the degree of awareness in patients with injury head which numbered 34 samples. This research statistics tests using simple regression. Result: The results of the study showed that there is a positive influence critical value mean artery pressure against the degree of awareness that indicated the value of p=0.00<0.05 and value of mean artery pressure is able to detect the level of consciousness patients injury head of 77.8%. Discussion: Increased critical value mean arterial pressure is more than 65 mmHg can improve mikrosirkulasi and autoreglasi brain, so that prevent the decline of awareness in patients with wounds of the head

Factors Affecting Commitment Midwives Implementation in 7T Minimum Care Standards Antenatal Care in Konawe District

Coverage of K1 and K4 services in District of Konawe in 2012 was still low, namely 60.2% and54.2% respectively. A preliminary study revealed that commitment of village midwives inimplementing 7T minimum care standards in Antenatal Care (ANC) services was still low. Thisresearch aimed to identify factors influencing the commitment of village midwives in implementingthe 7T minimum care standards in ANC services in District of Konawe. This was observational analytic research with cross-sectional approach. Independent variablesconsisted of work condition, expectation, availability of jobs, compensation, personal value, andmoral obligation. On the other hand, commitment of village midwives was as a dependent variable.Data collection used a questionnaire. Number of samples were 80 village midwives selected usinga purposive sampling technique from 12 selected health centers in District of Konawe. Furthermore,data were analyzed using methods of bivariate (Chi Square test) and multivariate analyses (LogisticRegression test).The result of this research showed that most respondents had good commitment (51.2%), goodwork condition (62.5%), lack of expectation (52.5%), good availability of jobs (52.5%), goodcompensation (67.5%), good personal value (53.8%), and good moral obligation (61.5%). Theresult of bivariate analysis revealed that variables of expectation (p=0.045), availability of jobs(p=0.003), compensation (p=0.000), personal value (p=0.002), and moral obligation (p=0.005)had significant association with the commitment of village midwives. In contrast, the factor ofwork condition was not significant. Furthermore, variables of compensation (p=0.000; OR=7.9)and expectation (p=0.037; OR=2.9) jointly influenced the commitment of village midwives.As suggestions, there needs support and facilities of ANC services such as providing simplelaboratory equipment, providing compensation based on the standard, and increasing expectationof midwives to improve the their commitments in implementing 7T minimum care standards

Analisis Strategi Pelayanan Geriatri Berbasis Rumah Sakit Dengan Menggunakan Value Chain Di Rumah Sakit Islam Kendal

Peningkatan jumlah usia lanjut di Kabupaten Kendal berdampak pada kenaikan pasien geriatri di RSI Kendal namun belum terlayani secara holistik. Bisnis Plan tentang layanan unggulan geriatri belum jelas sehingga perlu dilakukan upaya untuk memberikan nilai tambah pada pelayanan. Tujuan penelitian untuk menganalisis penerapan strategi value chain pada pelayanan rawat jalan geriatri yang berbasis rumah sakit di RSI Kendal. Jenis penelitian ini adalah kualitatif. Pengambilan data dengan tehnik wawancara mendalam. Subyek penelitian terdiri dari empat orang informan utama yaitu Direktur, Manager Pelayanan, Manager SDM, Kepala Ruang Rawat Jalan , sedangkan dua orang dokter spesialis , satu orang perawat poli Dalam dan satu perawat poli Syaraf sebagai informan triangulasi. Analisis data dilakukan dengan analisis isi. Hasil penelitian menunjukkan bahwa kekuatan nilai pada pelayanan geriatri berada pada letak geografis, kepuasan pelayanan, mutu pelayanan yang didukung oleh budaya yang profesional serta sumber daya tehnologi untuk kelas C. Kelemahan nilainya terletak pada perawat pemberi pelayanan yang belum terstandar sebagai perawat gerontik dan belum adanya survey pasar pelayanan geriatri. Pelayanan geriatri masih dilayani dipoli penyakit dalam, syarat dan fisioterapi. Proses analisis pada relevansi kompetitif memberikan gambaran bahwa pelayanan geriatri memiliki nilai yang sangat dihargai, langka, sulit ditiru dan berkesinambungan. Simpulan penelitian ini adalah pelayanan geriatri memiliki keunggulan kompetitif dan strategi yang dapat diterapkan adalah diferensiasi. Disarankan kepada manajemen untuk mengevaluasi bisnis plan dengan melakukan penelitian pasar dan perencanaan SDM marketing. An increasing number of elderly peopel in Kendal district led to a rise in RSI Busines Plan of geriatric services have not been clearly superior to the Kendal geriatric patients but has not been served in a holistic manner. analysis of value chain in the pre service, point service, and after service in order to provide added value to the service as a competitive relevance as an input in determining the business strategy. The purpose of the study to analyze the application value chain strategies to service-based outpatient geriatric hospital in Kendal RSI. The research is a qualitative with depth interview techniques. The subjects of the study consisted of four main informants is Director, Service Manager, HR Manager, Head of Outpatient Installation, while two specialist doctors, one of interna's nurse and one of nurse In Neural's poli as informant triangulation. The results showed that the strength of the value of the services geriatrics is at the geographical location, service satisfaction, quality of service, supported by a professional culture and technology resources for class C. The weakness lies in the value of nurses who have not been standardized service providers as a nurse gerontik and lack of care of the elderly market surveys. Care of the elderly is still served in outpatient poly and physiotherapy. The process of competitive analysis on the relevance of the idea that the care of the elderly has a value that is greatly appreciated, rare, difficult to imitate and sustainable. Conclusions This study is the care of the elderly have a competitive advantage and strategies that can be applied is differentiation. It is recommended to management to evaluate busines plan to conduct market research and marketing planning of huma

Implementasi Program Manajemen Terpadu Balita Sakit (MTBS) Puskesmas Wilayah Kabupaten Pasuruan

Pada tahun 2006 sosialisasi program MTBS dan pelatihan kepada petugas puskesmas telahdilakukan, dimana masing-masing Puskesmas diwakili oleh 1 orang tenaga medis (dokter)dan 2 orang tenaga paramedis (bidan, perawat). Akan tetapi kematian Balita di kabupatenPasuruan mengalami kenaikan, yaitu tahun 2007 sebesar 5,2/1000 kelahiran hidup, tahun2008 sebesar 5,4/1000 kelahiran hidup dan tahun 2009 sebesar 6,1/1000 kelahiran hidup. Darikematian tersebut diketahui penyebabnya antara lain karena gizi buruk, pneumonia, DBD,diare serta infeksi. Oleh karena itu perlu dilakukan analisis terhadap faktor faktor dalamimplementasi program MTBS di Puskesmas Kabupaten Pasuruan. Jenis penelitian adalahdeskriptif kualitatif, metode sampling yang digunakan adalah purposive sampling. Sebagaiinforman utama adalah petugas MTBS (dokter, bidan, perawat) di Puskesmas wilayahperkotaan dan pinggiran kota yang melakukan MTBS, berjumlah 12 orang. Sedangkansebagai informan triangulasi adalah 4 kepala Puskesmas, satu Kasie Kesga Dinas KesehatanKabupaten Pasuruan. Variabel dalam penelitian ini adalah faktor komunikasi, faktor sumberdaya, faktor disposisi, serta faktor struktur birokrasi. Penelitian memberikan hasil sosialisasidan pelatihan program MTBS sudah dilakukan. Petugas yang melayani Balita sakit belummenunjang keberhasilan pencapaian tujuan MTBS oleh karena belum semua petugasmendapatkan pelatihan MTBS, jumlah petugas tidak sebanding dengan jumlah Balita sakityang berkunjung. Seluruh petugas MTBS mempunyai sikap positif untuk mendukungprogram MTBS. Meskipun sudah tersedia SOP namun tidak semua petugas menggunakannyadalam melayani MTBS.Pembinaan dari DKK belum dilakukan rutin, supervisi masihbersifat umum, serta tidak ada tindak lanjut yang diberikan. Agar pelayanan MTBS terlaksanadengan baik maka perlu ditingkatkan sosialisasi SOP yang disertai pelatihan yang meratauntuk semua petugas serta supervisi yang spesifik pada MTBS

Pengaruh Kualitas Jasa Dan Nilai Pelanggan Terhadap Minat Kunjungan Ulang Melalui Kepuasan Pasien Di Poli Umum Di RSISA Semarang

Kepuasan pasien merupakan salah satu indicator dalam menilai mutu pelayanan di rumah sakit. Data jumlah kunjungan total pasien yang fluktuatif dan adanya trend penurunan jumlah kunjungan pasien lama di poliumum RSISA Semarang dalam kurun waktu 2010-2013 menunjukan ada permasalahan pelayanan di poli umum. Penelitian ini bertujuan untuk menganalisis secara keseluruhan apakah kualitas jasa dan nilai pelanggan mempunyai pengaruh terhadap minat kunjungan ulang melalui kepuasan pasien rawat jalan di poli umum RSISA Semarang .Penelitian ini merupakan penelitian explanatory, pendekatan waktu cross sectionalmetode analitik kuantitatif. Populasi penelitian adalah pasien rawat jalan poli umumdi RSISA Semarangyang telah berobat minimal 2 kali dengan metode penetuan sampel menggunakan Purposive Sampling.Jumlah sampel sebanyak 125 orang responden. Data dikumpulkan, menggunakan kuesioner dengan item pertanyaan terstruktur dan pengukuran skala Likert 1-5. Pengolahan dan analisis data menggunakan SEM dengan software Smart PLS 2.0. Hasil penelitian berdasarkan analisis menunjukan bahwa kualitas jasa dan nilai pelanggan berpengaruh positif dan signifikan terhadapkepuasan pasien. Kepuasan pasien berpengaruh positif dan signifikan terhadap minat kunjungan ulang. Kepuasan pasien yang dapat dijelaskan oleh kualitas jasa dan nilai pelanggan sebesar 45,3% , sedangkan minat kunjungan ulang pasien yang dapat dijelaskan oleh kualitas jasa, nilai pelanggan dan kepuasan pasien sebesar 45,0%Secara keseluruhan kualitas jasa dan nilai pelanggan di poliumum RSISA Semarang baik tetapi masih perlu perbaikan pada ketepatan jadwal pelayanan, ketersediaan informasi pelayanan yang tepat, petugas yang konsisten bersikap sopan, memberi salam, menyapa dan senyum kepada pasien sehingga dapat meningkatkan kepuasan pasien yang akhirnya dapat meningkatkan pula minat kunjungan ulang pasien berobat di poli umum RSISA SemarangPatient's satisfaction is one of the indicators in assessing a service quality at a hospital. Fluctuations in number of total visit of patients and declining trend of old patient visit number at a general polyclinic at Sultan Agung Islam Hospital (SAIH) in Semarang during the period of 2010-2013 indicated that there were any problems at the polyclinic. The aim of this study was to comprehensively analyse a service quality and customer value that influenced towards willingness to revisit through patient's satisfaction at outpatient/general polyclinic at SAIH in Semarang.This was an explanatory study using cross-sectional approach and an analytic method. Population was all patients at outpatient unit/general polyclinic at SAIH in Semarang who had visited the polyclinic at least two times. As many as 125 respondents were selected as samples using a method of purposive sampling. Data were collected using a structured questionnaire and measured using Likert scales of 1-5 and analysed using SEM performed by software of Smart PLS 2.0. The results of this research showed that the service quality and the customer value positively significantly influenced patient's satisfaction. In addition, the patient's satisfaction positively significantly influenced willingness to revisit. The patient's satisfaction could be explained by the service quality and the customer value equal to 45.3%. Meanwhile, willingness to revisit could be explained by the service quality, the customer value, and the patient's satisfaction equal to 45.0%. Overall, the service quality and the customer value at the general polyclinic of SAIH in Semarang are good. Notwithstanding, there still needs improvement in timeliness of service, availability of accurate service information, consistent and polite officers, greetings, and smiling to patients in order to improve patient's satisfaction and to increase willingness to revisit at the general polyclinic of SAIH in Semarang

Analisis Persepsi Perawat terhadap Budaya Keselamatan Pasien dengan Pendekatan Institute For Healthcare Improvement di Rsjd Dr. Amino Gondohutomo Kota Semarang

The Lack of nurses perception on patient safety culture could be one of the causes of about 60 incidents in a year in RSJD Dr. Amino Gondohutomo. Nurses have an important role in communication, where communication becomes important in patient safety. The aim is to determine nurses perception on patient safety culture with Institute for Healthcare Improvement approach in RSJD Dr. Amino Gondohutomo Semarang. Method used was qualitative descriptive by using interview guidelines as instrument, The primary Informant are 5 nurses in UPIP. Result, the nurse perception that involved patient in safety initiation is deficient, because it is done when the patient, in to get information related to patient's history.Relay patient safety report in shift changes is already done with procedurs. Conduct safety briefing is deficient because it is only done as the evaluation when the incident occurred, not as a precaution. Open culture, just culture, reporting culture, learning culture, and informed culture have been created although few things need to be done to improve the safety culture. Suggestions do family gathering regularly, conduct patient safety briefing, inform incident reporting procedues, and for nurses more open in discussion of patient safety

Peningkatan Prestasi Sekolah Menggunakan Bimbingan Teknis Pengelolaan Kegiatan Ekstrakurikuler

Tujuan penelitian ini untuk mengetahui: pelaksanaan kegiatan ekstrakurikuler di SDN Kadipaten II sebelum diberi bimbingan teknis oleh kepala sekolah; pelaksanaan kegiatan ekstrakurikuler di SDN Kadipaten II setelah diberi bimbingan teknis oleh kepala sekolah; keberhasilan bimbingan teknis yang dilaksanakan oleh kepala sekolah terhadap pencapaian prestasi sekolah. Penelitian tindakan sekolah ini dilakukan pada bulan September tahun 2011 sampai dengan bulan April 2012 di SDN Kadipaten II Kabupaten Majalengka, dengan metode action research dengan pendekatan penelitian tindakan yang bersifat partisipatif dan kolaboratif.Penelitian ini menggunakan desain Kemmis dan Taggart. Hasil penelitian menunjukan bahwa: Setelah setelah dilaksanakan bimbingan teknik oleh kepala sekolah dapat berjalan dengan baik, guru mempunyai program, pembagian tugas, penjadwalan, dan pemantauan, sehingga kegiatan ekstrakurikuler dapat dilaksanakan secara efektif; Terjadi peningkatan prestasi yang signifikan. pada tahun 2011 memperoleh 14 kejuaraan, sedangkan pada tahun 2012 memperoleh 33 kejuaraan pada kegiatan Festival Pendidikan dan O2SN tingkat Kecamatan Kadipaten

Analysis of Organizational Culture Change Processin Badan Rumah Sakit Umum Tabanan-Bali

Badan Rumah Sakit Umum (General Hospital Board= BRSU) Tabanan-Bali had changed inmany aspects of organization since 2002. These changes had a significant impact on the way togive further services, increasing the number of patients' visit and staff welfare. These changes, ingeneral, had changed the hospital image. Objective of the study was to analyze the process ofhospital organizational culture change (basic assumption, value system, norm, and artifact) onstructure, technology, and person aspects through the transformation steps (refreezing, freezing, and unfreezing). This was an observational, qualitative study. Data were collected through in-depth interview, documentary collection, and direct observation. Study subjects consisted of fourhospital managers (top and middle) as main informants, three functional staffs (physician andnurses) as triangulation informants. Results of the study showed that, at the beginning, therewere differences on BRSU organization. The differences included basic assumptions, valuesystem, norm, and artifact. Status of the BRSU was UPTD; and this BRSU had minimaltechnology, fraudulence revenue in every unit, and low quality of staffs. These situationsmotivated hospital director (as an initiator) to change hospital organization culture.Implementation of the change was to give understanding and awareness to all hospital staffsthrough giving vision and mission of the hospital, basic trust, norms, artifacts, and motto.Changes included 1) change of hospital status by District leader and district house ofrepresentative, from UPTD to LTD. This change was conducted according to accreditationstandard, ISO, and Citra cup service; 2) change on hospital information system (SIM-RS),communication system, and conducting KSO of instruments; 3) change of the quality of hospitalhuman resource. Impact of the changes included 1) increase in 1999-2000 hospital revenue from350-400 million rupiahs to 1.6 billion rupiahs, 2) significant increase on the staffs' wages. Supervision was conducted by the presence of an auditors, credential, and periodic refreshment of organizational culture. Impact of the whole changes was improvement of service quality. Inaddition, no service quality disruption was found after twice changes of hospital directors. Thecurrent type of organizational culture in BRSU Tabanan was an open organizational culturetype. Suggestion: changes will certainly occur, and BRSU Tabanan is expected to continuously control the changes towards the better, physically and non-physically

Evaluation on Rooming in Mardi Rahayu, Kudus

Infant mortality rate in Indonesia was high. Scientific evidence showed that infants with formula milk had higher probability to die than infant with exclusive breastfeeding. Implementation of ‘Sayang Ibu dan Anak\u27 hospital movement was done by performing rooming in program. Objective of this study was to evaluate the implementation of rooming-in program in Mardi Rahayu hospital Kudus. This was a descriptive-qualitative study. Study subjects were five main informants as policy makers, and five triangulation informants as executors of the program. Data were collected through in- depth interview. Content analysis method was applied in the data analysis. Results of the study showed that output aspect was not good; rooming in for mother and child were conducted ± 2 hours/day; formula milk was still given. Input aspect: human resource was not standardized to the type B hospital worker standard. Budget for each program was not equal; availability, sufficiency, and feasibility of facility were good. Third class post delivery room was not complete and uncomfortable. Not all standard operating procedure was performed. Marketing was not done. Process aspect was inadequate. Leader\u27s policy was made; socialization, actuating, and coordination were not done; monitoring and evaluation were not done; no commitment from the leaders and executors in the implementation of rooming in. In conclusion, Mardi Rahayu hospital performed partial rooming in; formula milk was still given. Human resource aspects were not suitable with type B hospital standard; budgeting program was not equal; facilities for third class were not suitable with the standard. Not all SOP was performed; marketing was insufficient, and no collective commitment was done. It was suggested to do total rooming-in, and to give formula milk according to the indication; to do lactation management training, breast milk counselor and supporter training, to conduct monitoring and evaluation