Analysis of Occupational Health and Safety Risk using Hiradc Method in Medical Record Installation at Nganjuk Hospital

The processing of medical record files has an important role to support the achievement of administrative order in efforts to improve health services in hospitals. This study aims to see how the process of processing medical record files at the Petala Bumi Regional General Hospital, Riau Province 2022. The research method used is qualitative analytics. The informant consisted of 6 people, namely the Head of the Medical Support Services Section, the Head of Medical Record Installation and 4 medical record officers. How to collect data with in-depth interviews and observations at the Petala Bumi Regional General Hospital, Riau Province. Research shows that Human Resources in Medical Record Installations are still lacking and medical record file processing training has not been carried out thoroughly to officers. Facilities and infrastructure to support the work of officers are inadequate. In the assembling section, there are still incomplete documents. Coding officer had difficulty in reading the doctor's writing and the diagnosis was not found in the ICD-10 book The process of indexing medical records has not been carried out in full. In the reporting of the hospital SIMRS is still in the process of being refined. The analysis section has not been intense in the communication of the medics with the medical records officers. The filling part of the medical record file storage system lacks storage racks and narrow storage space. It is necessary to add medical records officers and infrastructure in the Medical Record Intalation. The process of processing medical record files needs accuracy and clarity in terms of completeness and diagnosis. In the filling section, it is necessary to add a medical record file storage rack and expand the storage space so that the medical record file processing process can run effectively and efficiently.

Retention of medical records is carried out because medical records will continue to grow until the storage rack is full and there is no longer enough so that medical records will not be stored forever in the storage room. The results of observations in the preliminary study at RSUD Dr. H. Moch. Ansari Saleh, inactive medical records are still not stored in the inactive storage room as they should be. This study aims to review the retention of medical records in RSUD Dr. H. Moch. Ansari Saleh Banjarmasin from preparation, implementation to evaluation. This research method uses qualitative research with a case study design. The subjects of this study were taken using a purposive sampling technique with the subject of 1 Head of Medical Record and 3 Medical Record Officers at Dr. Hospital. H. Moch. Ansari Saleh Banjarmasin. The results of the study found that the preparation of medical record retention in RSUD Dr. H. Moch. Ansari Saleh Banjarmasin already has a policy, for the schedule there are still SOPs for retention, special human resources to carry out retention already exist, while the retention implementation facilities are still not sufficient to store inactive medical records. no treatment for 3 years and after being assessed for use, it will be destroyed using an incinerator machine, there are still obstacles, namely the limited space for storing inactive medical records. The conclusion of this study, the implementation of retention that is not in accordance with the existing SPO, an assessment is taken of a form that has value for storage, the obstacles found are the inactive medical record storage room in the active storage room.

Workload is a number of jobs that must be completed by a group or someone in a certain time. performance is the result of work that can be achieved by a person or group of people in an organization, in accordance with the authority and responsibility of each in order to achieve organizational goals. The filling room cannot be separated from the medical record officer who works in the room. To maintain the balance of workload with the performance of hospital employees must have special standards so that officers do not feel the workload is not balanced with employee performance. This study aims to determine the relationship between workload and employee performance in the Filling Room for Medical Record Installation at Bhayangkara Hospital, Palembang. The population that became the unit of analysis in the study was employees in the installation of medical records at Bhayangkara Hospital in Palembang with a total sampling technique totaling 16 respondents. The type of research used is quantitative research using the correlation method through the Cross Sectional approach. The data analysis technique used is chi square with SPSS17.0 computer software tools. With the Ha hypothesis test there is a relationship between workload and performance in the filling room of the medical record installation of Bhayangkara Hospital Palembang and H0 there is no correlation between workload and employee performance in the filling room for medical record installation at Bhayangkara Hospital Palembang. Based on the results of the study there was no relationship between workload and employee performance

Potential health problems for workers are work accidents and occupational diseases. The International Labor Organization (ILO), 1 worker in the world dies every 1 second due to work accidents and 160 workers experience work-related illnesses. Based on the results of interviews conducted with 10 workers, 6 of them had experienced work accidents such as slipping, being contaminated with chemicals from animal feed and being scratched by sharp objects while the other 4 workers had no work accidents. The purpose of this study was to determine the factors associated with occupational safety and health risks in laying hens at PT. Livestock Friends of West Binjai District, Binjai City in 2022.The study used an analytic survey method with a cross sectional approach. The research population consisted of 50 workers with a sample of 50 people taken using the total sampling technique. Data analysis used univariate and bivariate analysis with the chi-square test statistic.The results showed that variable knowledge (p=0.015), use of PPE (p=0.008) and work environment (p=0.001) with occupational health and safety risks in laying hen farm workers.The conclusion of this study is that there is a relationship between knowledge, use of PPE and work environment with occupational safety and health risks in laying hen farm workers. It is suggested that this research can be used as input for the management, regarding the importance of implementing occupational safety and health to prevent work accidents, such as providing training to workers, providing PPE according to the needs of workers.

Background: Medical record has a purpose to achieve an orderly administrative in an increasing health effort. UU RI no. 29 of 2009 section 46 and 47 said that every doctor and dentist should be make an medical record in their practices. If they violate, they can be penalized accordance with the provisions. In this research, needs analysis seen from some aspect, the amount of resources, education, skill, and work motivation. Ken Saras Hospital Medical record installation suffer fairly high turnover in 2013, so it make increasingly heavy workload for the employees who still survive.Medical Records Installation in Ken Sarah Hospital has been regeneration at sometime ago, so it made heavy workload for resources who still survive. .The purpose of this research is to determine the workload of resources, the suitability of the workload and the need that based on workload. Method: This research used qualitative descriptive study with cross sectional approach. Data collection used work sampling method and in-depth interview. The population in the study was the time used medical record personnel in completing the work and the whole effort implementing IRM in a total of 11 people. Result: The results of this research is the ideal amount of medical record resources from amount of power aspect , education, skills and nowadays work motivation of resources. According the result of this research is 3.07 hours of workload, 3.3 hours of productive time, education, skill, and work motivation affect the work system of instalation. The workload in registration section is 5.88 hours, and 5.9 hours of productive time. Educational standards in irm is good enough, but need to add 1 resource in registration section with D3 RM standart. IRM skills is good enough, but need the training of medician recorder to improve the skill. Work motivation is still lacking. According this research, can be concluded that there's deficiency in medical record installation, 1-2 resources. The registration section with high school education competencies, need procurement training to improve the knowledge resources, and need some activities to improve work motivation

Consensus-based generalized TODIM approach for occupational health and safety risk analysis with opinion interactions

The aim of this research is to determine and analyze: (1) Work Culture (2) Work Environment; (3) Employee Performance; and (4) The influence of work culture and work environment on the performance of medical records installation employees at the Cibabat Regional General Hospital, Cimahi City, both simultaneously and partially.The research method used in this research is a descriptive survey and an explanatory survey, the unit of analysis in this research is the employees of the Medical Records Installation at the Cibabat Regional General Hospital, Cimahi City with a sample of 30 people. The type of investigation is causality, and the time horizon in this research is cross-sectional.Based on the research results, it was found that the work culture experienced by employees of the Medical Records Installation at the Cibabat Regional General Hospital, Cimahi City was good, the work environment at the Medical Records Installation at the Cibabat Regional General Hospital, Cimahi City could generally be said to be good, the performance of the employees at the Hospital Medical Records Installation In general, the Cibabat area of ??Cimahi City is currently considered good. Work Culture and Work Environment influence the Performance of Medical Records Installation Employees at the Cibabat Regional General Hospital, Cimahi City simultaneously and partially. However, partially the dominant work culture influences employee performance rather than the work environment.Because work culture predominantly influences performance, it is the first priority in improving performance. Therefore, the Medical Records Installation at the Cibabat Regional General Hospital, Cimahi City is recommended to improve working conditions and atmosphere, so that they are able to work more professionally

In implementing health services, puskesmas must document all actions and treatments that are given to patients in a document called Medical Records. According to Minister of Health Regulation No.269 / MENKES / PER / III / 2008 article 1 (1), medical records are files containing notes and documents about patient identities. Medical records are of good quality if the medical record is accurate, complete, trustworthy, valid and timely. One form of management in Medical Records is reporting. According to Minister of Health Regulation No.269 / MENKES / PER / III / 2008 article 1 (1), Medical Record is a file that contains notes and documents about patient identity, examinations, actions, and other services that have been given to patients. In the statement, all information about a patient has been reflected which will be made the basis for determining further actions in services and other medical actions given to a patient who comes to the community health center. The Medical Record is said to be of high quality if the Medical Record is accurate, complete, trustworthy, valid and timely. The Medical Record Installation has activities such as registration, data processing, and storage. One form of processing data in medical records is the existence of assembling activities. Assembling is an assembling activity compiling empty Medical Record forms and storing them into Medical Records, ready to use neatly arranged both in terms of quality and quality.

At Makassar City Hospital, one of the service indicators that has not been achieved is in incomplete medical record files and medical record files that are returned more than 2x24 hours after service. This study aims to analyze the implementation of the completeness of filling in and the timeliness of returning inpatient medical record files at the Makassar City Hospital. This type of research is mixed methods research. The study design used a cross-sectional approach. The study was conducted in September - October 2020. The results showed that the implementation of completeness of filling in and the timeliness of returning medical record files was still low, this has led to the accumulation of medical record files in the treatment room and delays in returning the files of inpatients to the medical record installation of the City Hospital Makassar. Training on the implementation of medical records has not been comprehensive for all officers at the Makassar City Hospital. The result of the delay in returning the documents is the delay in payment of insurance claims to the hospital. Accumulation of medical records in the treatment room from incomplete medical records and returned to the treatment room. Health workers who forget to fill in complete medical records are only given a sanction in the form of a warning during a meeting with the medical committee. Availability of SOP on filling and returning medical record files at the hospital. The facilities and infrastructure in the implementation of medical records are still insufficient for medical record employees at Makassar City Hospital. It is recommended that the hospital improve the implementation of the completeness and timeliness of returning medical record files, provide incentives or rewards for completing filling in, increase the number of computers and expand the room in the medical record installation, and review the medical record format at Makassar City Hospital

The study aims to analyze the occupational safety and environmental health risks due to aircraft painting at the Hangar of PT. XYZ. The study is a descriptive study with a qualitative approach. The results of the study are the analysis of occupational safety risks seen from occupational safety risks and risk control. Occupational safety risks in aircraft painting activities at PT. XYZ are divided into several parts, namely (1) Exposure to hazardous chemicals is included in the high category; (2) The risk of work accidents is included in the moderate category; (3) Equipment damage is included in the low category; and (4) Fire is included in the low category. Risk control can be carried out by (1) Increasing strict supervision of the aircraft painting process; (2) Conducting appropriate occupational safety training for workers; (3) Using PPE; (4) Using adequate safety equipment; and (5) Carrying out proper equipment maintenance. The analysis of environmental health risks is seen from environmental health risks, sources of risk and risk control. Environmental health risks are divided into several parts, namely (1) Air pollution is included in the moderate category; (2) Soil and water contamination is included in the moderate category; and (3) Environmental damage is included in the moderate category. Sources of environmental health risks are the use of hazardous chemicals and painting waste. Risk control can be done by carrying out strict supervision, using safe chemicals and proper waste management.

The medical record installation must maintain medical records correctly and appropriately, including the return of medical records. According to the Ministry of Health (2006), the standard for returning inpatient medical records is ≤ 2x24 hours after completion of treatment. Meanwhile, the standard of service effectiveness in the form of time for providing outpatient medical records according to Kepmenkes number 129 of 2008 is ≤ 10 minutes. The purpose of the study was to determine the relationship between inpatient medical record return time and service effectiveness. The research method used is quantitative with a cross-sectional design. The population is 220 medical records of post-inpatient patients who are controlled outpatients at Ciremai Hospital during January 2022. The total sample is 145 using the Slovin formula with the purposive sampling technique. Univariate analysis using frequency distribution and bivariate analysis using the Spearman rank correlation test are used because the data is not normally distributed. The results show that the average time to return inpatient medical records is 115,86 hours, the fastest time is 24 hours, and the longest time is 360 hours. The average service effectiveness in the form of outpatient medical record provision was 222,26 minutes; the fastest time was 3 minutes; and the longest time was 710 minutes. The Spearman rank correlation coefficient is 0,418 with a p-value of 0,000 ≤ 0,05. The conclusion is that there is a relationship with moderate correlation strength between inpatient medical record return time and service effectiveness, with a value of 0,418.

One form of administrative service at the hospital is the medical record service. The problem in the medical record installation at DKT Sidoarjo Hospital is the waiting time for outpatient medical record services. Based on Permenkes RI No.129/Menkes/SK/II/2008 for patient medical record services at outpatient registration, namely > 10 minutes. This study aims to determine the factors that influence the waiting time for medical record services at outpatient registration at DKT Sidoarjo Hospital. The research method is descriptive with instruments in the form of observations and interviews conducted with the head of medical records and medical records officers in the registration section. The results of this study indicate that the factor that greatly influences the waiting time for medical record services at TPPRJ DKT Sidoarjo Hospital is medical record activities, namely the provision of medical records in the storage section. On the Man Factor, namely the number of officers and educational qualifications of officers who are not from medical records. On the Money Factor there are no funds for the education and training of registration officers and no rewards for officers who are disciplined and friendly in service. In the Methode Factor the use of Registration SOP is not optimal. In Material Factors there is no use of tracers on storage racks. On the Machine Factor, namely frequent errors on SIMRS when performing services.

Background Medical Record according to Permenkes No.269/Menkes/Per/III/2008, Medical Record is a file that contains notes and documents about the patient's identity, examination results, treatment that has been given to the patient. Health facilities are responsible for protecting health information contained in medical records against possible loss, damage, falsification and unauthorized access. Maintaining information security, accuracy of information and ease of access to information are demands of health service organizations and health practitioners as well as authorized third parties. Meanwhile, parties who need information must always respect patient privacy. Overall, security, privacy, confidentiality and safety are devices that fortify information in medical records [1]. The purpose of this study was to determine the review of the release of medical record information in ensuring the legal aspects of the confidentiality of medical records at Kencana Hospital. Research method The research design used is descriptive research, which is a research method whose purpose is to present a complete picture of the social setting by describing a number of variables that are relevant to the problem and the unit under study among the phenomena being tested. This type of research is used to determine the process of providing medical record information and guaranteeing the legal aspects of medical record confidentiality at Kencana Hospital. The population in this study were all officers involved in the process of providing medical record information at Kencana Hospital which had 8 employees, which were divided into 3 medical record officers (1 head of medical records and 2 people served as distribution and retrieval officers), 2 people who handles related to insurance and 2 officers handles related to BPJS. In this study, the sample used was the party from the medical record unit, namely the medical record officer who has the authority in the process of providing patient medical information to a third party. The instruments used are Checklist Sheets and interview guidelines. In this study, the sampling used was purposive sampling technique because in sampling the authors considered certain things related to the research, The results of the research on Standard
 
 
 Operating Procedures related to providing patient medical information at the Kencana Hospital have an SOP. This SOP contains points for the process of releasing patient medical information, each point with a slightly different procedure depending on who the 3rd party is requesting. What is meant by 3rd parties here are patients, insurance companies, and legal institutions (courts). Each of these 3rd parties has made their respective procedures. The parties involved in the process of releasing patient medical information at Kencana Hospital are all medical record officers totaling 15 people (8 officers in the filing section), (2 people in the distribution of medical record files), and (5 people in the registration section). The information released is in the form of a photocopy of a medical resume sheet. At Kencana Hospital, the only party who can decide on the release of patient medical information is the medical record officer. Kencana Hospital does not yet have special security related to the process of releasing patient medical information, but if a patient is represented in the process of requesting release of information, the representative must have a power of attorney from the patient concerned. If the request for release of information is not represented, the patient will be given a release approval form from the medical record unit. Suggestion It is better to make Standard Operating Procedures related to the Release of Patient Medical Information referring to the Regulation of the Minister of Health of the Republic of Indonesia Number 36 of 2012 concerning Medical Secrets and Guidelines for the Implementation and Procedures of Indonesian Hospital Medical Records issued by the Director General of Yanmed.

Background Medical Record according to Permenkes No.269/Menkes/Per/III/2008, Medical Record is a file that contains notes and documents about the patient's identity, examination results, treatment that has been given to the patient. Health facilities are responsible for protecting health information contained in medical records against possible loss, damage, falsification and unauthorized access. Maintaining information security, accuracy of information and ease of access to information are demands of health service organizations and health practitioners as well as authorized third parties. Meanwhile, parties who need information must always respect patient privacy. Overall, security, privacy, confidentiality and safety are devices that fortify information in medical records [1]. The purpose of this study was to determine the review of the release of medical record information in ensuring the legal aspects of the confidentiality of medical records at Kencana Hospital. Research method The research design used is descriptive research, which is a research method whose purpose is to present a complete picture of the social setting by describing a number of variables that are relevant to the problem and the unit under study among the phenomena being tested. This type of research is used to determine the process of providing medical record information and guaranteeing the legal aspects of medical record confidentiality at Kencana Hospital. The population in this study were all officers involved in the process of providing medical record information at Kencana Hospital which had 8 employees, which were divided into 3 medical record officers (1 head of medical records and 2 people served as distribution and retrieval officers), 2 people who handles related to insurance and 2 officers handles related to BPJS. In this study, the sample used was the party from the medical record unit, namely the medical record officer who has the authority in the process of providing patient medical information to a third party. The instruments used are Checklist Sheets and interview guidelines. In this study, the sampling used was purposive sampling technique because in sampling the authors considered certain things related to the research, The results of the research on StandardOperating Procedures related to providing patient medical information at the Kencana Hospital have an SOP. This SOP contains points for the process of releasing patient medical information, each point with a slightly different procedure depending on who the 3rd party is requesting. What is meant by 3rd parties here are patients, insurance companies, and legal institutions (courts). Each of these 3rd parties has made their respective procedures. The parties involved in the process of releasing patient medical information at Kencana Hospital are all medical record officers totaling15 people (8 officers in the filing section), (2 people in the distribution of medical record files), and (5 people in the registration section). The information released is in the form of a photocopy of a medical resume sheet. At Kencana Hospital, the only party who can decide on the release of patient medical information is the medical record officer. Kencana Hospital does not yet have special security related to the process of releasing patient medical information, but if a patient is represented in the process of requesting release of information, the representative must have a power of attorney from the patient concerned. If the request for release of information is not represented, the patient will be given a release approval form from the medical record unit. Suggestion It is better to make Standard Operating Procedures related to the Release of Patient Medical Information referring to the Regulation of the Minister of Health of the Republic of Indonesia Number 36 of 2012 concerning Medical Secrets and Guidelines for the Implementation and Procedures of Indonesian Hospital Medical Records issued by the Director General of Yanmed.

ABSTRACT
 Security is a method of securing information against unauthorized change access. Confidentiality is a limitation for disclosing certain personal information. Based on preliminary observations, it was found that the medical record storage room of the "X" Hospital was not protected and confidential. The door storage room was not locked so that officers other than medical records could enter, it was found that the patient brought his own medical record without being accompanied by a medical record officer, and there were damaged medical records.
 The result of this research is that security and confidentiality policies and standard operating procedures already exist, but have not been maximally implemented. Security and confidentiality aspects of medical records have not been properly maintained. Judging from the intrinsic factor there are still folders that have not used plastic coated material. From the extrinsic factors there are medical record doors that have not used an access code and always open, and there are damage to medical record files due to rats and cockroaches. it is advisable to reaffirm and socialize the provisions set out in the policy and standard operating procedures to carry out activities in accordance with applicable regulations.
 Keywords: Security and confidentiality; stronge space; medical record