A Qualitative Study on the Patient Safety Management at Sumbawa Hospital, West Nusa Tenggara

Background: Patient safety is an important element of an effective, efficient health care system where quality prevails. Patient safety is a crucial issue and a focus of policy standard in internationally accredited organizations. The specific committee responsible for quality improvement in patient safety is the committee for Quality Improvement and Patient Safety. Incidence of malpractice often occurs but are not reported. It indicates that the committee has not worked according to required accreditation standard. This study aimed to analyze patient safety management with the committee for quality improvement and patient safety at Sumbawa Hospital, West Nusa Tenggara. Subjects and Method: This was a qualitative study with phenomenology approach. Nine study participants were selected purposively, consisting of 3 committee members (chair person, secretary, and patient safety sub-committee), 3 chiefs of ward (pediatrics, internal medicine, and surgery), and 4 nurses or midwives (pediatrics, surgery, ICU/ ICCU, and obstetrics). Results: The Quality Improvement and Patient Safety committee has been established at Sumbawa Hospital, West Nusa Tenggara to meet the requirement of hospital accreditation standard. It aimed to improve the quality of services and to assure patient safety. However, its work has not meet the required standard. The lack of knowledge among involving parties, including hospital management, Quality Improvement and Patient Safety committee member, medical professionals was identified as one important obstacle for the implementation of patient safety management. This has led to the incidence of malpractice at the hospital, sub-standard quality of services and patient safety. Conclusion: The Quality Improvement and Patient Safety committee has been established at Sumbawa Hospital, West Nusa Tenggara. However, their work have not meet the required standard. The lack of knowledge among involving parties, including hospital management, Quality Improvement and Patient Safety committee, and health professional, has led to the incidence of malpractice at the hospital, sub-standard quality of services and patient safety.It’s important to remember that most hospital errors can be prevented. Hospitals need to work hard every day to protect their patients from errors, injuries, accidents, and infections. Keywords: quality improvement, patient safety management, committe

A Qualitative Study on The Work Performance of Nutrition Technicians in Nutrition Control in Medan, North Sumatera

Background: Malnutrition continues to be a major public health problem throughout the developing world, particularly in southern Asia and sub-Saharan Africa. Malnutrition is the most important risk factor for the burden of disease in developing countries. It is the direct cause of about 300,000 deaths per year and is indirectly responsible for about half of all deaths in young children. Nutrition technicians play a key role in providing quality, cost-effective client care, and food service management. Nutrition technicians work to plan menus and prepare food for people with special nutritional needs. This study aimed to assess the work performance of nutrition technicians in nutrition control in Medan, North Sumatera. Subjects and Method: This was a qualitative study conducted in Medan, North Sumatera. A sample of nutrition technicians, health center doctors, municipality health office administrators, and mothers who had malnourished children, was selected for this study. The theme of study was work performance in nutritional control. The data were collected by in-depth interview, direct observation, and document review. Results: Work performance of nutrition technicians was still sub-optimal so that some of the nutrition recovery program target were not achieved. This problem arose due to various causes, including (1) limited number, low skill, low discipline, and low motivation of the nutrition technicians; (2) lack of monitoring and supervision by health center doctor and municipality health office administrator; (3) limited infrastructure and facilities. Conclusion: Work performance of nutrition technicians is still sub-optimal due to limited number and low motivation, lack of monitoring and supervision by health center doctor and municipality health office. Keywords: performance, nutrition technicians, nutrition contro

Qualitative study in Loop Quantum Cosmology

This work contains a detailed qualitative analysis, in General Relativity and in Loop Quantum Cosmology, of the dynamics in the associated phase space of a scalar field minimally coupled with gravity, whose potential mimics the dynamics of a perfect fluid with a linear Equation of State (EoS). Dealing with the orbits (solutions) of the system, we will see that there are analytic ones, which lead to the same dynamics as the perfect fluid, and our goal is to check their stability, depending on the value of the EoS parameter, i.e., to show whether the other orbits converge or diverge to these analytic solutions at early and late times.Comment: 12 pages, 7 figures. Version accepted for publication in CQ

Singularities and qualitative study in LQC

We will perform a detailed analysis of singularities in Einstein Cosmology and in LQC (Loop Quantum Cosmology). We will obtain explicit analytical expressions for the energy density and the Hubble constant for a given set of possible Equations of State. We will also consider the case when the background is driven by a single scalar field, obtaining analytical expressions for the corresponding potential. And, in a given particular case, we will perform a qualitative study of the orbits in the associated phase space of the scalar. eld

Qualitative study in Loop Quantum Cosmology

This work contains a detailed qualitative analysis, in General Relativity and in Loop Quantum Cosmology, of the dynamics in the associated phase space of a scalar field minimally coupled with gravity, whose potential mimics the dynamics of a perfect fluid with a linear Equation of State (EoS). Dealing with the orbits (solutions) of the system, we will see that there are analytic ones, which lead to the same dynamics as the perfect fluid, and our goal is to check their stability, depending on the value of the EoS parameter, i.e., to show whether the other orbits converge or diverge to these analytic solutions at early and late times.Comment: 12 pages, 7 figures. Version accepted for publication in CQ

A Qualitative Study on Knowledge and Dietary Intake among Mothers with Stunted Children Under Five in Jepara, Central Java

Background: Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median. Some of the consequences of stunting in early life include poor cognition and educational performance, low adult wages, lost productivity and, when accompanied by excessive weight gain later in childhood, an increased risk of nutrition-related chronic diseases in adult life. This study aimed to describe perception of stunting and analyze the associations of maternal knowledge and dietary intake on the risk of stunted children under five in Jepara, Central Java. Subjects and Method: This was a qualitative study conducted in Jepara, Central Java. A sample of 44 stunted children under five years of age was selected for this study. A sample of mothers of the stunted children was selected as key informants. The dependent variable was stunting. The independent variables were maternal knowledge and child dietary intake. The data on stunting were taken from maternal and child health record at Puskesmas. The other data were collected by in-depth interview, focus group discussion, and document review. The data were analyzed by content analysis. Results: Mothers of stunted children did not worry about their children condition. Stunting was not considered as a serious issue to overcome. Mothers had poor knowledge about stunting, dietary intake, and child health were poor. Conclusion: Stunting in children under five to some communities in Jepara, Central Java, is not considered as an important issue. Correspondingly mothers of stunted children have poor knowledge about stunting, nutrition, and child growth and development. Keywords: stunting, maternal knowledge, dietary intake, children under five

Qualitative Study on Pet-Related Human Behaviour and Other Risk Factors of Rabies in Buleleng, Bali

BACKGROUND: Bali has been an endemic province since 2008. Rabies cause specific death was 8, 1, and 2, respectively, in 2012, 2013, and 2014. Number of dog or cat bites was 55836, 44690, and 46877, respectively, in 2012, 2013, and 2014. The study aimed to explore pet-related human behavior and other risk factors of rabies in Buleleng, Bali. SUBJECT AND METHODS: This was a qualitative study conducted in poor communities living in Bulian village, Kubutambahan sub-district, Buleleng district, Bali. Twenty households were purposively selected for this study. The key informants included household members, heads of hamlet, and head of village. The data were collected by in-depth interview, direct observation, and document review. RESULTS: House condition and sanitation were acceptable, despite low socio-economic position of community members. Dog population was high. Most of them lived wild, unattended, or did not have identity neck-lace. Ten out of 20 household interviewed reported that their members were bitten by dog over the past year. Most of the dogs had never been vaccinated. Most of the villagers had poor knowledge and practice on how to treat wounds. Villagers usually let the dogs that had bitten human to live free or killed them immediately. CONCLUSION: Uncontrolled of dog population, widespread unvacci-nated dogs, uncontrolled dog mobility, lack of proper knowledge and practice on wound treatment, were the main risk factors of rabies incidence. Keywords: rabies, dog bite, pet-related human behavior, risk facto

A Qualitative Study on the Management Information System, Primary Care, and Bridging Data System at Community Health Center in Sukoharjo District

Background: In the 21st century, health information and data is asserting itself as the equally important counterpart to the more physical aspects of medicine. It’s still a developing field, but people interested in health and wellness should be aware of the fact that it has already had a significant impact on the healthcare industry and is only gaining momentum as its full usefulness becomes clear. Community health center management information system or often referred to as SIMPUS is a local health system aimed at providing health information at primary health care level. Primary Care (P Care) application is an information system that is designed to serve BPJS patients. The bridging system links SIMPUS with P care application. These three systems have been used in all puskesmas in Sukoharjo district since 2017. This study aimed to evaluate the implementation of community health center management information system, Primary Care, and bridging data system, in Sukoharjo District, Central Java. Subjects and Method: This was a qualitative study conducted in Sukoharjo, Kartasura, Bendosari, Mojolaban community health centers, in Sukoharjo District, Central Java, from October to December 2017. Four community health centers were selected randomly from 13 community health centers in Sukoharjo. The dependent variables were information service, performance, efficiency, and security. The independent variable was health information system (SIMPUS, P care, and bridging system). The data were collected by in-depth interview, direct observation, and document review. Data credibility was checked by triangulation. Results: Three health information systems (SIMPUS, P care, and bridging system) have been implemented in Sukoharjo District. However, their performance is yet to be improved. Loading time was lengthy and error often occured. Patients often complained of the lengthy service. Some items in the information system form were left blank. Data entry occasionally was inconsistent with examination outcome. Security system of the health information existed, but sometimes unauthorized individuals can access and use that information. There was a lack of human resources and hardware. The health information system had not met the information need. Conclusion: SIMPUS, P care, and bridging system have been implemented in Sukoharjo District. However, their performance is yet to be improved. Some obstacles have yet to be resolved. Keywords: evaluation, SIMPUS, P care application, bridging syste

The value of choice: A qualitative study

Background Providing choice in health care is part of an ongoing policy initiative Aim To explore how people understand choice in health care provision Setting South East England Design of Study A qualitative study using semi structured interviews Method Twenty two people recruited through advertising were interviewed about choice in general and choice in health care in particular. The data were analysed using template analysis. Results Participants grounded their consideration of choice in the NHS within the GP consultation. Four main themes about choice were identified: positive aspects of choice; the appearance of choice; unwanted choice; and the role of information in choice. In particular, there was strong assent to the value of choice in principle and having choice was seen as positive. The provision of choice options, however, was not always associated with the possibility of meaningful choice and participants felt that the appearance rather than the substance of choice was sometimes in evidence. Making – as opposed to having - choice was often unwanted and considered as indicative of erosion in trust in the GP and to occasion regret. Information was seen as a necessary but not sufficient prerequisite of informed choice Conclusion People value having choices rather than making choices but are concerned about choice provision for its own sake rather than choice that is available in a meaningful way. Health care policy that recommends an increase in choice per se may be met with scepticism which could ultimately undermine rather than promote the doctor / patient relationship