Determinan Infeksi Luka Operasi Pascabedah Sesar

Infeksi luka operasi (ILO) adalah bagian dari infeksi nosokomial dan merupakan masalah dalam pelayanan kesehatan, terjadi pada 2 - 5% dari 27 juta pasien yang dioperasi setiap tahun dan 25% dari jumlah infeksi terjadi di fasilitas pelayanan. Penelitian bertujuan mengetahui hubungan usia, status gizi, jenis operasi, lama rawat prabedah, kadar Hb, transfusi darah, waktu pemberian antibiotik profilaksis, jenis anestesi, lama pembedahan serta lama rawat pascabedah dengan kejadian ILO pada pasien pascabedah sesar di RSUP Dr. Sardjito Yogyakarta. Rancangan desain penelitian studi observasional prospektif dilakukan dengan sampel 154 orang. Data diperoleh melalui observasi menggunakan daftar tilik sejak pasien masuk rumah sakit sampai 30 hari pascabedah. Analisis data meliputi analisis univariat, analisis bivariat dengan menggunakan uji kai kuadrat serta analisis multivariat dengan uji regresi logistik berganda. Hasil penelitian menunjukkan ada hubungan antara waktu pemberian antibiotik profilaksis (OR = 1,16; 95% CI = 1,09 - 1,37), lama rawat prabedah (OR = 1,12; 95% CI = 1,02 - 1,24) dan lama rawat pascabedah (OR = 1,21; 95% CI = 1,04 - 1,39) dengan kejadian ILO. Faktor lainnya tidak mempunyai hubungan yang signifikan terhadap kejadian ILO. Hasil uji regresi logistik ganda menemukan lama rawat pascabedah merupakan faktor yang paling dominan terhadap kejadian ILO. Identifikasi faktor risiko ILO dapat bermanfaat untuk merencanakan upaya meminimalkan kejadian ILO pada pasien pascabedah sesar. Surgical site infection (SSI) is part of health care associated infection and remains a problem in hospital care. SSI occurs in 2 to 5% of the 27 million patients having surgery each year and 25% of infections occur in care facilities. This study aimed to relation various such as age, nutritional status, type of surgery, pre-operative length of stay, hemoglobin level, bloodtransfusions, timing of antibiotics prophylaxis, type of anesthesia, duration of operation and post-operative length of stay on the incidence of SSI post caesarean section at Dr. Sardjito Hospital Yogyakarta. Prospective observation study was conducted in 154 sample. Data were obtained through observations using checklist since hospital admission up to 30 days post surgery. Data analysis included univariate, chi-square test and multiple logistic regression. The result showed that time of prophylactic antibiotics (OR = 1.16; 95% CI = 1.09 - 1.37), pre-operative length of stay (OR = 1.12; 95% CI = 1.02 - 1.24) and post-operative length of stay (OR = 1.21; 95% CI = 1.04 - 1.39) were risk factors for SSI. Other factors did not show significant associations with incidence of the SSI. The findings from multiple logistic regression showed post-operative length of stay in hospital as the most dominant factor for incidence of SSI. Identifying SSI risk factors can be used to plan efforts to minimize the occurrence of SSI in post-caesarean section patients

Effect of Patient Centered Care Application on Inpatient Outcomes in Rskdia Pertiwi and Rsia Ananda (Woman and Child Hospitals)

BACKGROUND: Patient-centered care (PCC) is a new paradigm in healthcare that places patients as the center of care to improve health outcomes and increase patient and family satisfaction. AIM: The study aimed to evaluating the effect of PCC application on inpatient outcomes, notably patient satisfaction, and clinical outcomes in RSKDIA Pertiwi and RSIA Ananda. METHODS: The study was quantitative analytic with cross-sectional design. A sample of 92 patients were determined proportionally, and selected with the inclusion criteria. Data were collected using measuring tools consisting of PCC questionnaires, patient satisfaction questionnaires, and patient medical record to evaluate the clinical outcomes of patient. Bivariate analysis was carried out to compare the PCC application between the two hospitals, and multivariate analysis to correlate the effect of PCC application to patient satisfaction, and clinical outcomes of inpatient in each hospital. RESULTS: There was effect of PCC application on patient satisfaction in RSKDIA Pertiwi (p = 0.017) and RSIA Ananda (p = 0.000), but there was no effect show to the clinical outcomes in RSKDIA Pertiwi (p = 0.718) and RSIA Ananda (p = 0.440), also there was no differences in the application of PCC (p = 0.492) between both hospitals. CONCLUSION: It can be concluded that the application of PCC attributed to patient satisfaction, but did not affect the clinical outcomes of inpatients at RSKDIA Pertiwi and RSIA Ananda; also there were no differences of PCC application between both hospitals. The hospitals management should improve the application of PCC, particularly in coordination of care

FAKTOR YANG BERHUBUNGAN DENGAN KINERJA PERAWAT DALAM IMPLEMENTASI SASARAN KESELAMATAN PASIEN DI RAWAT INAP RUMAH SAKIT STELLA MARIS MAKASSAR TAHUN 2016

Penelitian ini dilatarbelakangi karena adanya insiden keselamatan pasien selama tiga tahun terakhir seperti 24 kasus KTD, 91 kasus KNC dan enam kasus KPC. Insiden keselamatan pasien bisa disebabkan oleh kinerja perawat yang kurang baik. Penelitian ini bertujuan untuk mengetahui hubungan sumber daya, kepemimpinan, imbalan, struktur organisasi dan desain pekerjaan dengan kinerja perawat dalam implementasi sasaran keselamatan pasien di rawat inap RS Stella Maris Makassar. Jenis penelitian ini adalah survei analitik dengan pendekatan cross sectional study. Populasi penelitian ini adalah seluruh perawat rawat inap sebanyak 105 perawat. Pengambilan sampel menggunakan teknik exhaustive sampling. Analisis yang dilakukan adalah analisis univariat dan bivariat dengan uji chi square. Hasil penelitian ini menunjukkan bahwa sumber daya (p=0,003), kepemimpinan (p=0,000), imbalan (p=0,002), struktur organisasi (p=0,003) dan desain pekerjaan (p=0,000) berhubungan dengan kinerja perawat dalam implementasi sasaran keselamatan pasien. Kesimpulan terdapat hubungan antara sumber daya, kepemimpinan, imbalan, struktur organisasi dan desain pekerjaan dalam implementasi sasaran keselamatan pasien di rawat inap RS Stella Maris Makassar

Maturity Level of Patient Safety Culture in Makassar City Hospital

The maturity of a patient safety culture is a step in developing a hospital patient safety culture. This research aims to determine the maturity level of patient safety culture in Makassar City hospitals. Furthermore, it is a quantitative study with a cross-sectional approach and was carried out at Public and Private Hospitals with the 2012 KARS Plenary level accreditation status in 2020. The purposive sampling method was used for the selection of the study locations and the selected hospital was the RSUD Haji Makassar, Hasanuddin University Hospital Makassar (belonging to the Ministry of Education and Culture), and Awal Bros Makassar Hospital (privately owned). The determination of the sample size was adjusted to the total number of employees of the hospital in which the research wasperformed, namely about 474 samples. The data collection tool contains a patient safety culture questionnaire based on the MaPSaF (Manchester Patient Safety Framework) instrument containing 5 levels of patient safety culture. The results showed that the maturity level of the patient safety culture in Makassar City hospital, the generative category was the largest choice, namely 391 respondents (82.5%) and the least in the reactive category was 1 respondent (0.2%). The three hospitals have maturity levels of patient safety in the generative category. It is hoped that the Makassar City hospital will be able to maintain the maturity of patient safety culture by paying attention to teamwork and responsibility by implementing a patient safety culture

Effect of Quality of Dental Health Services to Patient Satisfaction in Indonesia 2019: Importance-Performance Analysis

Objective: To determine the effect of the quality of dental health services based on dimensions of empathy and responsiveness to patient satisfaction in urban and rural areas in Bone District, Indonesia. Material and Methods: This survey used an analytical observational method with a pilot pathfinder survey design. The total of participants included in this survey was 442, with 223 in the urban area and 219 in the rural area. This survey was held on 25 February – 1 March 2019. The Mann-Whitney test was applied, adopting a significance level of 5%. Results: Empathy and responsive dimensions in urban (3.58 ± 0.94 and 3.50 ± 0.94) and rural (3.43 ± 0.99 and 3.63 ± 0.86) areas were in the moderate category. The administration staff was able to complete administrative procedures, and the Dental assistant responded promptly to the patient\u27s request and needs. Conclusion: The quality of empathy and responsiveness dimensions in dental treatment fall in the moderate category for urban and rural areas; this means that empathy and responsiveness dimensions in dental service in hospital/public health need to be improved

Hubungan Stres Kerja Dan Beban Kerja Dengan Kelelahan Kerja pada Perawat di RSUDTenriawaru Kelas B Kabupaten Bone Tahun 2018

Selama dua tahun terakhir ini RSUD Tenriawaru Kelas B Kabupaten Bone mengalami peningkatan jumlah pasien yang dibuktikan dengan Bed Occupancy Rate (BOR), hal ini membuat beban kerja para perawat semakin bertambah, semakin bertambahnya beban para perawat semakin bertambah tingkat kelelahan yang dirasakan perawat dan jika hal ini terus berlanjut akan terjadi penurunan produktivitas kerja dan dapat memicu terjadinya stres kerja. Penelitian ini bertujuan untuk menganalisis hubungan antara beban kerja dan stres kerja dengan kelelahan kerja pada perawat RSUD Tenriawaru Kelas B Kabupaten Bone Tahun 2018. Penelitian ini menggunakan metode penelitian observasional analitik, dengan menggunakan pendekatan Cross Sectional, dan mengambil 65 perawat untuk menjadi responden dengan menggunakan teknik purposive sampling yaitu teknik dengan tujuan atau pertimbangan tertentu yang memenuhi kriteria inklusi hasil kriteria inklusi. Pengumpulan data dilakukan dengan menggunakan kuesioner yang telah diuji validitasnya. Uji statistik yang di gunakan yaitu uji univariat dan bivariat. Hasil penelitian menunjukkan bahwa perawat yang merasakan kelelahan tinggi sebanyak 43,1%. Perawat dengan beban kerja sedang sebanyak 61,5%. Perawat yang mengalami stres sedang sebanyak 95,4%. Hal ini menunjukkan bahwa terdapat hubungan yang signifikan antara stres kerja dengan kelelahan kerja (p = 0,001) dan terdapat hubungan antara beban kerja dengan kelelahan kerja (p = 0,001)

Hubungan Mutu Pelayanan dengan Kepuasan Pasien di Instalasi Rawat Inap Rumah Sakit Ibnu Sina YW-UMI

Making patients satisfaction as the main orientation is one of the characteristics of quality health service. This study aims to analyze patient satisfaction in relation with respondent characteristics and dimensions of service quality. This research was quantitative study with cross sectional approach on Ibnu Sina Hospital. Sample obtained were 242 people selected by consecutive sampling. Data obtained through the results of the distribution of questionnaires which were then analyzed using the Spearman correlation test. The dimensions of technical competence (p = 0.026), effectiveness, efficiency, service continuity, safety, and interpersonal relations with (p = 0.000) were dimensions that have significant relation. The dimensions of access to services (p = 0.177) and amenities (p = 0.516) were dimensions that have not a significant relation with patient satisfaction. There is a significant relationship in six of the eight dimensions of service quality. Suggestions for this study to improve the aspects of nurses' attitudes and skills, nurse awareness to identify patients, alacrity to patients, communication skills, especially nurses in conveying patient's condition to the doctor, and educate patient about risk accident at the hospital

GAMBARAN IMPLEMENTASI SASARAN KESELAMATAN PASIEN OLEH PERAWAT DI RUANG RAWAT INAP RUMAH SAKIT UNIVERSITAS HASANUDDIN

Pelayanan yang tidak berkualitas memberikan dampak yang negatif bagi komponen yang ada di rumah sakit seperti terjadinya insiden keselamatan pasien sehingga pentingya program implemetasi keselamatan pasien. Implementasi keselamatan pasien di ruang rawat Inap Rumah Sakit Universitas Hasanuddin dilihat dari lima sasaran keselamatan pasien yaitu ketepatan identifikasi pasien; komunikasi efektif; peningkatan keamanan obat; pengurangan risiko infeksi; dan pengurangan risiko pasien jatuh. Kelima sasaran ini menjadi variabel penelitian ini. Penelitian ini melihat gambaran implementasi perawat terhadap sasaran keselamatan pasien di ruang rawat inap Rumah Sakit Universitas Hasanuddin. Desain penelitian adalah penelitian kuantitatif dengan pendekatan komparatif deskriptif. Teknik pengambilan sampel menggunakan exhaustive sampling sehingga diperoleh responden sebanyak 80 orang. Adapun responden pada penelitian ini yaitu perawat yang berada di ruang rawat inap. Analisis data menggunakan analisis univariat dan bivariat. Dari penelitian yang dilakukan diperoleh sebanyak 75 responden dikarenakan 5 responden sedang cuti pada saat penelitian berlangsung. Hasil penelitian menunjukkan implementasi baik pada sasaran ketepatan identifikasi pasien (69,3%), komunikasi efektif (53,3%), keamanan obat (58,7%), pengurangan risiko infeksi (68,0%), dan pengurangan risiko pasien jatuh (54,7%). Dapat ditarik kesimpulan bahwa perawat telah mengimplementasikan kelima sasaran keselamatan pasien dengan baik

Performance Measurement Using MBNQA (Malqolm Baldridge National Quality Award) Criteria at Makassar Islamic Hospital

The application of improving the quality of service is very much needed in this era of globalization. Malcolm Baldrige Criteria for Performance Excellence-(MBCfPE) better known as the Baldrige Criteria is one method that can provide a solution to this problem. This study aims to analyze the implementation of Total Quality Management using the MBNQA criteria at the Isalam Faisal Hospital in Makassar. This type of research is a quantitative research using an observational study with a cross sectional study design. Collecting data in the form of a questionnaire. The sample in this study were all staff and leaders at the Faisal Islamic Hospital in Makassar, amounting to 258 respondents. The results showed, based on MNQA calculations, Faisal Islamic Hospital Makassar was at the Igood Performance level with a value of 738. The final conclusion of measuring the performance of Faisal Islamic Hospital Makassar with this score illustrates that the performance of Faisal Makassar Islamic Hospital is still not good. Therefore, proactive planning needs to be made and implemented, not only reactive to problems. It is suggested to the hospital management that it is necessary to conduct an evaluation using the PDCA cycle method, so that the strategic plan that has been made can be carried out effectively

PENGUKURAN KINERJA DENGAN PENDEKATAN BALANCED SCORECARD DI INSTALASI GAWAT DARURAT RSUD Dr. M. HAULUSSY AMBON

Pendahuluan. Balanced scorecard merupakan metode yang dapat mengukur kinerja keberhasilan rumah sakit yang bukan keberhasilan finansial atau untuk mencapai tujuan jangka pendek saja tetapi mempertimbangkan aspek non finansial dan dapat menawarkan pemetaan strategis yang sistimatis dan komprehensif bagi rumah sakit. Tujuan. Penelitian ini bertujuan untuk mendapatkan gambaran kinerja dengan menggunakan pendekatan balanced scorecard di instalasi gawat darurat RSUD Dr. M. Haulussy Ambon. Metode. Penelitian ini menggunakan metode kuantitatif, dengan sampel pelanggan sebanyak 147 responden dan sampel pegawai instalasi gawat darurat sebanyak 36 responden, sedangkan data kualitatif dilakukan dengan wawancara mendalam. Hasil. Hasil penelitian menggambarkan kinerja instalasi gawat darurat dari perspektif pelanggan dalam kondisi kurang sehat dengan total score 62,5%, dari perspektif keuangan dalam kondisi tidak sehat dengan total score 25%, sedangkan perspektif proses bisnis internal dalam kondisi kurang sehat dengan total score 60,7%, serta perspektif pembelajaran dan pertumbuhan dalam kondisi sangat sehat dengan total score 70%, untuk kinerja instalasi gawat darurat secara umum berada dalam kondisi kurang sehat dengan total score 58,02%, dimana rumah sakit lebih cenderung untuk berfokus pada aspek internal, orang dan non finansial. Kesimpulan. Kinerja instalasi gawat darurat dari perspektif pelanggan berada dalam kondisi kurang sehat, dari perspektif keuangan dalam kondisi tidak sehat, untuk perspektif proses bisnis internal berada dalam kondisi kurang sehat, serta dari perspektif pembelajaran dan pertumbuhan dalam kondisi sangat sehat. Sedangkan kinerja instalasi gawat darurat secara keseluruhan berada dalam kondisi kurang sehat dan belum adanya keseimbangan baik antar perspektif maupun antar aspek-aspek keseimbangan (internal-eksternal, proses-orang dan keuangan-non keuangan)