Local Government Hospital Research Articles

Management Support in Implementing A Career Path System for Nurses in Local Government Hospitals

Career ladder systems are an important mechanism in supporting the professional development of nurses and have been implemented in various models in a number of countries. Effective management support is critical to the successful implementation of career ladder systems in Indonesia. This study aims to determine the description of management support in the implementation of career ladder system in Local Government Hospitals. This study is a quantitative study with a cross-sectional design conducted in May-June 2024. The study population was all nurses who applied for competency assessment and credentialing/recredentialing as many as 76 people who also became samples with total sampling technique. Data were analyzed using descriptive statistics including frequency distribution and percentage. These questionnaires have undergone validity and reliability testing, with Cronbach's alpha values of 0.905 for the Management Support Questionnaire and 0.927 for the Nursing Career Path Questionnaire. The results showed that the majority of executive nurses were female (92%) with vocational education (84%) and were in early adulthood (26-35 years old). Most of them had between 8 to 15 years of service and almost half of them were at the Pre PK level (43%). Management support in implementing career ladders was mostly categorized as good (54%). This study concludes that management support in the implementation of the career ladder system in Local Government Hospitals is mostly good, but there are still some aspects that need to be improved. Optimal management support includes the provision of adequate resources, structured training programs, and continuous feedback to ensure the successful implementation of the career ladder system.

Management Support in Implementing a Career Path System for Nurses in Local Government Hospitals

Management Support in Implementing a Career Path System for Nurses in Local Government Hospitals

Understanding of Nurses as Causative Factor of Physical Health, Mental Health and Emotional Aspect of Nurses in Local Government Hospital

Nurses facilitate the entire health care journey from hospital admission to discharge. This role gives them unique perspective and power to drive positive patient outcomes. However, understaffing of nursing personnel in local government hospital is causative factor that leads to resignations, change of profession, moving to another hospital with a higher salary, and migration to other countries. Thereby intensifying the shortage in local government hospitals like Ospital ng Lungsod ng San Jose Del Monte of Bulacan. Qualitative narrative research method was used in this study. Interview guide questions were validated by experts in the academe with chosen nurse supervisors, head nurses and staff nurses as participants. The study affirmed the opinions and ideas of the nurses on understaffing in the Ospital ng Lungsod ng San Jose Del Monte, Bulacan. Moreover, this study revealed the negative effects of understaffing in the physical health, mental health and emotional challenges of nurses in the said hospital. Based on the results of the study enhancement of policies on the nurse staffing towards the well-being of nurses was framed.

Acute Poststreptococcal Glomerulonephritis at a Single Center Before and During the Pandemic

Background: Acute poststreptococcal glomerulonephritis (APSGN) remains an important cause of hospitalization among pediatric patients in low- to middle-income countries. During the pandemic, healthcare delivery faced further challenges, delaying diagnosis and management of childhood illnesses, which may contribute to disease severity. Limited studies explore the state of diagnosis and treatment of APSGN before and during the pandemic. Objective: The objective of this study was to compare the demographic, clinical, and laboratory profiles of pediatric patients diagnosed with APSGN before the pandemic (2017–2019) versus during the pandemic (2020–2022) and to determine which factors are associated with length of hospital stay (LOS). Methodology: An analytic cross-sectional study was conducted in a local government hospital. Medical charts of 102 patients <18 years old clinically diagnosed with APSGN based on hematuria, edema, hypertension, and/or oliguria admitted from January 2017 to December 2022 were reviewed. Results: The mean age of patients was 7 years; 57 (56%) were female. Demographic, clinical manifestation, and laboratory profiles were not significantly different before and during the pandemic (all P > 0.05). The median LOS was 6 days. Elevated blood urea nitrogen (BUN) (adjusted odds ratio [OR] =1.04; P = 0.018) and low C3 level (adjusted OR = 0.97; P = 0.042) were significantly associated with LOS. Conclusion: The demographic, clinical, and laboratory profiles of APSGN patients before and during the pandemic were comparable. Elevated BUN and low C3 levels are significantly associated with LOS.

Genetic diagnosis of endocrine disorders in Cyprus through the Cyprus Institute of Neurology and Genetics: an ENDO-ERN Reference Center

The report covers the current and past activities of the department Molecular Genetics-Function and Therapy (MGFT) at the Cyprus Institute of Neurology and Genetics (CING), an affiliated Reference Center for the European Reference Network on Rare Endocrine Conditions (Endo-ERN).The presented data is the outcome of > 15 years long standing collaboration between MGFT and endocrine specialists from the local government hospitals and the private sector. Up-to-date > 2000 genetic tests have been performed for the diagnosis of inherited rare endocrine disorders. The major clinical entities included Congenital Adrenal Hyperplasia (CAH) due to pathogenic variants in CYP21A2 gene and Multiple Endocrine Neoplasia (MEN) type 2 due to pathogenic variants in the RET proto-oncogene. Other rare and novel pathogenic variants in ANOS1, WDR11, FGFR1, RNF216, and CHD7 genes were also found in patients with Congenital Hypogonadotropic Hypogonadism. Interestingly, a few patients with Disorders of Sexual Differentiation (DSD) shared rare pathogenic variants in the SRD5A2, HSD17B3 and HSD3B2 while patients with Glucose and Insulin Homeostasis carried theirs in GCK and HNF1A genes. Lastly, MGFT over the last few years has established an esteemed diagnostic and research program on premature puberty with emphasis on the implication of MKRN3 gene on the onset of the disease and the identification of other prognosis biomarkers.As an Endo-ERN member MGFT department belongs to this large European network and holds the same humanistic ideals which aim toward the improvements of health care for patients with rare endocrine conditions in respect to improved and faster diagnosis.

Well-being of the students – What matters?

Anxiety disorders are highly prevalent globally and it is much more prevalent among adolescents because of their exposure to a variety of stressors. Research shows that emotional and biopsychosocial well-being changes over the course of their schooling, with a general increase in anxiety, highlighting the need to further investigate the risk factors that contribute to worry and anxiety symptoms among college student populations. In Mauritius, there has been a rise in the number of adolescents who are recipients of psychiatric treatments at the local government hospitals as well as an increase in the number of cases reported to the school authorities. The present study aimed to identify the causal factors of anxiety among adolescents, and its effects in the educational context. Further, the role of educational social workers in overcoming anxiety was explored and the aim was achieved using the exploratory approach. A focus group discussion using a semi-structured questionnaire was conducted with ten (10) people including educational social workers and educational psychologists recruited through convenience sampling. A thematic analysis of the data shows academic anxiety as an emerging factor, followed by bullying and lastly, family issues. The findings revealed impacts at the school level such as students’ inability to concentrate in class, non-participative and also showing emotional distress. While educational social workers provide counselling to students and parents, a need for teacher empowerment and peer counselling are proposed as future avenues.

Beliefs and misconceptions about hypertension disease: A qualitative study among patients in a peri-urban community in Ghana.

This study aims to explore beliefs and perceptions about hypertension among patients living with hypertension in a local district in the Eastern region of Ghana. A descriptive qualitative approach was adopted, and the Health Belief Model was used to guide the data collection, analysis, and organization of the study findings. Overall, seventeen participants were interviewed. In-depth interviews were conducted using a semistructured interview guide. Participants were conveniently selected from a district local Government Hospital. Data gathered were transcribed verbatim and analyzed using thematic analysis. Almost all the participants acknowledged hypertension as a severe but chronic illness that can cause sudden death. They also identified that lifestyle practices and individual attitudes were associated with the hypertension condition's causes, management, and control. The findings revealed several unscientific misconceptions and beliefs about hypertension, which could influence their disease management and control decisions. Patients' decisions on alternative treatment for hypertension are primarily based on beliefs and misconceptions based on the information they receive from unregulated media and peers. The prevention and control of hypertension should focus on behavior and lifestyle modification which needs reinforcement through health education and promotion.

Home rehabilitation using android-based system as booster on the independences of stroke patients in local government hospital in Aceh, Indonesia.

The independence of stroke patients played the main role in not only preventing the asymptomatic attacks which delayed assistance but also enhancing their quality of life by reducing their dependence on family members or caregivers. However, the inaccessibility and expense of treatment prevented stroke patients from continuing their rehabilitation and exercise after returning home. Thus, the purpose of this study was to provide an efficient system for alternative home rehabilitation to boost the self-care Independence of stroke patients by designing Android-based home rehabilitation. The quantitative research was conducted using a non-randomized trial where the patients were purposively sampled. 70 participants were joined and divided into two groups: the control and intervention groups. The intervention group will have SIMTROKE application on their smartphone as the home rehabilitation process where control group would not have SIMTROKE installed. The effect of home rehabilitation was assessed by univariate, bivariate analysis and the correlation matrix to analyze home rehabilitation effect to the participants' self independences. The result showed that the independent intervention in post-stroke patients has a significant effect on increasing the independence of stroke patients to improve their quality of life of stroke patients. The highest improvements were found in urination and toileting followed by defecation, dressing, active and phase motion range, self-care, stepping to stairs, mobilization, showering, and eating abilities. The result proved that home rehabilitation utilizing an Android-based system could be employed as an alternate method to assist stroke patients in improving their independence and quality of life. (www.actabiomedica.it).

PENERAPAN MANAJEMEN RISIKO DI UNIT KERJA RMIK

Background: TPPRJ as a leading unit that provides services to patients needs to minimize the risks and hazard that can be experienced by officers and patients. From a preliminary study at one of the local government hospitals in the Central Java region, it was found that at the outpatient registration point there was no Standar Procedur Operational (SPO) regarding risk management, so there was no standard set for risk control for officers and patients.Objective: The purpose of this study is to identify the application of risk management in the outpatient registration site (TPPRJ) of the hospital.Method: The type of research used in this study is qualitative descriptive with a case study design. The subjects of the study were 4 informants determined by purposive sampling techniques. Data collection through interviews and observationsResults: There are several risk factors in TPPRJ, namely from physical aspects (air temperature, lighting, radiation), biological aspects and ergonomic aspects. From the results of interviews and observations, it is known that the implementation of risk management in hospitals has been running, but it is still not optimal because it has not yet reached a comprehensive evaluation from the hospital's quality management.Conclusion: Risk management has been running but has not been maximized, because there is no SPO that specifically regulates risk management at TPPRJ. The risk management process that has been running is to identify risks, risk analysis and risk control.Keywords: Risk Management, RMIK Work Unit, TPPRJ

Developing Community-Based Palliative Care for Children: A Community Case Study from an Urban Informal Settlement in Bangladesh.

Globally, more than 97% of children needing palliative care reside in low- and middle-income countries, where there is very limited access to palliative care. Several community-based palliative care programs focused on adults, have been described in resource limited settings, suggesting a simple and low-cost approach to providing palliative care. The implementation of community-based palliative care for children has not previously been described. This community case study describes the implementation of an innovative model of community-based palliative care program in and urban informal settlement, (Korail Slum, Bangladesh). The program is led by a local government hospital, with experience in community-based palliative care, in partnership with the local community. Children with serious conditions in an urban unformal settlement do not have access to health services which address their medical, psychosocial and spiritual needs. This gap leads to a significant burden of preventable suffering for them and their families. A community-based palliative care program was implemented, which includes home care by trained community health workers, with support and supervision from palliative care nurses and physicians. The program's objective is to provide effective symptom management, clear communication about the child's condition with parents, and psychosocial support including support for basic needs. The program was free for families including medications, medical equipment, physiotherapy, and speech therapy. The program was monitored through regular assessments of quality of life using standardized tools (PedsQL Family Impact Module), as well as interviews and focus group discussions. A model of community-based palliative care for children can be implemented in an urban informal settlement. Program effectiveness is enhanced by community health workers who share language, culture, and life-experiences with the individuals they serve. Partnerships with local health care facilities and community groups strengthen the program's sustainability. Ensuring financial sustainability remains a challenge.

Seismic hazard analysis on Solok Regency, West Sumatra to support local government development program

Solok Regency is an administrative area located in West Sumatra that is currently carrying out disaster mitigation programs. Mostly, major infrastructure such as the Solok Local Government Buildings Complex, school facilities, hospital buildings, and many dense residential buildings are scattered over this area. One notable event happened on September 30, 2009, which forced the local government to take serious prevention steps to reduce casualties and damages in the future. Furthermore, there is a need to develop a comprehensive study to analyze the seismic hazards by determining the value of Peak Ground Acceleration (PGA) at the bedrock. The analysis was carried out using the Probability Seismic Hazard Analysis (PSHA) by calculating several seismic sources towards Solok regency by a radius of 500 kilometers from the Arosuka area for a 2475-year return period. The result showed a PGA value of 1.052g on Arosuka, Solok regency, while the Openquake platform shows the range of PGA values varies from 0.576g – 1.368g. The PGA values were then visualized into a seismic hazard map using a geographic information system (GIS). In addition, these scientific results are used as basic information to estimate the seismic vulnerability to support the disaster risk reduction program in West Sumatra.

Awareness of Dash Diet among Hypertensive Patients in Ido-Osi Local Government Hospitals, Ekiti State Nigeria

The study investigated the level of awareness of the DASH diet among hypertensive patients in Ido-Osi local government hospitals, Ekiti State Nigeria. The study adopted a descriptive survey design with three specific purposes, three research questions, and one null hypothesis to guide the study. The population of the study is 282 hypertensive patients, which include both in and outpatients from the seven local government hospitals who were present at the moment of data collection. No sampling technique was used as the whole of the population was used. A 27- item structured and validated questionnaire was used in the data collection and the data analysis was done using Mean and Standard deviation by SPSS version 20.0 and ANOVA for the analysis of the one null hypothesis. Cronbach Alpha Reliability Method was used to determine the internal consistency and 0.81 was obtained. The major findings of the study are the poor level of awareness of the DASH diet as revealed in their poor consumption of fruits and vegetables, consumption of red meat, sugars, sweets, saturated fats, and cholesterols among others. It also reveals that factors like illiteracy and economic factor among others challenge their awareness about the DASH diet. Strategies developed to increase awareness of the DASH diet among others include nutrition education and the installation of registered dietitians in government hospitals.

HISTOGENESIS OF HUMAN FETAL STOMACH AT VARIOUS GESTATIONAL AGES – AN OBSERVATIONAL STUDY

Objective: Knowledge on timelines of structural and histological development of fetal stomach helps in the diagnosis of abnormalities (duplication cyst of the pylorus, heterotopic pancreatic tissue, etc.,) and weighing interventions as an option. The present study was undertaken to establish the timelines of the developmental process of stomach (e.g., appearance of curvatures, gastric pit, gastric glands, and various cell types) correlating with the gestational age. Methods: Fifty normal, aborted and unclaimed fetuses were obtained from local private and government hospitals observing all formalities. The tissues of 3–5 mm thickness were taken and preserved in 10% formalin for 72 h, followed by tissue processing and staining with hematoxylin eosin and periodic acid Schiff and observations were made under microscope. Results: Lesser and greater curvatures appeared in the first trimester. All the four layers and gastric pits were observed at 16th week, cuboidal epithelium turns columnar and nidus of gastric glands, circular muscular layer submucuosa noted by 18th week, longitudinal layer of muscle appeared at 20th week, parietal, zymogenand mucus neck cells observed by 24th week in fundus, and body oblique muscle was evident by 28th week and near adult pattern seen by 32nd week of gestation. Conclusion: From the available literature, very few studies have reported regarding histogenesis of human fetal stomach in India. The present study is one such to supplement the known data and knowledge regarding histogenesis of human fetal stomach and help in diagnosis and treatment of related congenital anomalies.

Kepastian Hukum Pembukaan Rekam Medis Pasien COVID-19 Dalam Situasi Pandemi

medical record is a document made by a hospital containing the identity, examination, treatment, and medical actions taken against confidential patients. Medical records are medical secrets that can be shown or disclosed in certain situations, one of which is a pandemic situation. In the event of an outbreak of infectious disease, namely the COVID-19 pandemic situation, medical records belonging to COVID-19 patients can be used by doctors, hospitals, and researchers to identify and analyze the causes as well as be useful for the government to determine policy and regulatory directions to suppress virus transmission. Based on the Minister of Health Regulation on Medical Secrets which regulates the opening of medical records in a pandemic situation, there is a blurring of norms regarding legal certainty and procedures for opening medical records in a pandemic situation. To identify and analyze these problems, the researcher uses a normative legal research method with a conceptual approach and legislation. The results obtained that the opening of medical records of COVID-19 patients in a pandemic situation may only be opened to certain parties such as local government officials, hospital heads, and related parties who play a role in reducing the number of virus transmissions. In addition, the information in the medical record shown is only information related to epidemic control, so the patient's personal confidential information is maintained.

Risk Factors, Clinical Stage, and CD4 Counts on HIV-Infected Patients in Pregnancy at Local Government Hospital

Perinatal period was the third-highest of HIV/AIDS transmission in Indonesia.The information related to the prevalence of cases and risk factors of HIV in pregnancy in each area was still restricted. This research aimed to determine the risk factors, clinical stage, and CD4 counts in pregnant women with HIV at local government hospital. This research was carried out from medical records in Ibnu Sina Hospital from January 2013 to June 2020 and it used total sampling. We analyzed the association of risk factors (age, entry points, sexual risk group, weight, tuberculosis screening) with clinical stage and CD4 counts in pregnant women. Tuberculosis screening, antiretroviral therapy, and CD4 counts have an association with a clinical-stage in pregnant women with HIV with an odds ratio (OR) was 14.6, 12.0, and 0.1, respectively. Besides, only tuberculosis screening has an association with CD4 counts (p

Prediction of active filing shelf in medical record unit - General hospital Dr. H. Soewondo Kendal 2020 – 2024

General hospital Dr. H. Soewondo Kendal is a local government hospital. Improving medical support services, especially the quality of medical record archiving services, is essential to maintain the quality of hospitals in the context of good hospital standards. This study aims to predict the need for archive shelves between 2015-2019. The type of research used is descriptive with accidental sampling technique. Patient medical records were collected using a systematic sampling technique. The observation results showed that the average thickness of medical record documents was 0.85 cm based on measurements on 30 samples of medical record documents. The hospital has 48 shelves with 5 sub-shelves on each shelf. The length of the available archives is 525 cm and by 2024 a total of 37 shelfs will be needed. Modeling results based on linear regression equations have decreased medical record documents since 2015-2019 y = - 782.9x +30636. However, the linear regression validation for the cumulative medical record documents for 2015-2019 shows an increase based on the regression equation y = 28439 x + 1112.2, therefore it is necessary to immediately save the medical record document in an active state. The conclusion delivered by Dr. H. Soewondo Kendal does not need an additional archive shelf, but it does require inactive document storage.

Automatic identification of abnormal blood smear images using color and morphology variation of RBCS and central pallor

The anatomy of red blood cells (RBCs) in blood smear images plays an important role in the detection of several diseases. The automated image-based technique is fast and accurate for the analysis of blood cells morphology that can save time of both pathologists as well as that of patients. In this paper, we propose a novel method which segment and identify varied RBCs in a given blood smear images. In the proposed method, the central pallor and whole cell information are used, after using color processing followed by double thresholding of blood smear images. The shape and size variances of cells are calculated for the identification of abnormalities in peripheral blood smear images. We used cross-validation accuracy weighted probabilistic ensemble (CAWPE). It is a heterogeneous ensembling technique of nearly equivalent classifiers produced on averagely significant better classifiers (regarding errors and probability estimates) as compared to a wide range of potential parent classifiers. The proposed method is tested on 3 sets of images. The sets of images were prepared in a local government hospital by expert pathologists. Each image set has varied photographic conditions. The method was found accurate in term of results, closer to the ground truth. The average accuracy of the proposed method is 97% for the segmentation of single cells and 96% for overlapped cells. The variance (σ2) of accuracy is 3.5 and the deviation (σ) is 1.87.

Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2

ObjectivesIn many countries around the world, the COVID-19 pandemic has resulted in health services being diverted to manage patients with the condition. There are situations however that still require the undertaking of aerosol generating procedures (AGP) with potentially high exposure of healthcare workers to SARS-CoV-2 transmission through droplet, contact and possibly airborne routes. The objective of this paper is to explore a structured way for the operative team to approach AGP to reduce aerosolisation of secretions, decrease open airway time and minimise staff exposure. MethodsThe authors (otolaryngologists, anaesthetists and nursing staff) created a unified operative team checklist based on collation of national and international specialty society statements, local state government recommendations, hospital policies and literature review. Simulation was undertaken and the checklist was refined after performing AGP on patients with unknown (presumed positive) COVID-19 status. ResultsAn 8 step operative team checklist is provided describing details for the immediate pre-operative, intra-operative and post-operative journey of the patient to encourage healthcare workers to reflect upon and modify usual practice during AGP to mitigate exposure to SARS-CoV-2. The example of paediatric laryngo-bronchoscopy for diagnostic purposes or retrieval of an inhaled airway foreign body is used to illustrate the steps however the checklist structure is modifiable for other AGP and adaptable for local needs. ConclusionsAt a time of overwhelming and changing information and recommendations, an operative team checklist may provide some structure to healthcare workers undertaking AGP to reduce anxiety, maintain focus, prompt consideration of alternatives and potentially reduce risk.

How the participants of a Yoga Prana Vidya YPV) eye camp experienced vision improvements: A case study

Introduction: Yoga Prana Vidya (YPV) system based on ancient yogic practices, is an integrated approach known from experience to heal diverse human diseases and sicknesses holistically. This case study presents the outcomes of vision improvements of participants through Yoga Prana Vidya (YPV) healing techniques by conducting a two-week eye healing camp at Bangarpet, Karnataka. Materials and Methods: This is a case study method going into details of how the YPV eye camp was conducted. The YPV team collaborated with eye doctors of the local Government hospitals who screened and helped to identify a sample of 27eye patients. YPV healers performed healing daily on each patient. In addition, the patients were trained to practice some YPV techniques on daily basis. Patient feedback reports were also taken at the end of the intervention. Results: After receiving healing, vision improved for 23 participants from 80% to 100% within 5 to 10 days of healing. Seven of them could read without spectacles. However, for one patient cylindrical and spherical values were found to be higher than at intake, which needed further investigations. Three participants could not participate fully in the camp and discontinued for personal reasons. Conclusion: It is observed that the YPV process caused other positive effects also besides improvements in vision for most of them, indicating the holistic nature of YPV healing. Participants who regularly attended forgiveness prayer and breathing exercises had better results. A participant who had been suffering from insomnia reported getting quality deep sleep. Keywords: Eye disorders, Vision impairments, Optometric measurements, Yoga Prana Vidya Healing.

Experience and reflection on the construction of medical alliances in a government and hospital partnership model

Active exploration for building a model of medical alliances fitting local needs, proves imperative for the functional positioning of medical institutions, promoting inter-institutional cooperation and enhancing the capacity of primary medical services. The authors described experiences and insights of the No.1 Affiliated Hospital and the People′s government of Quangang District in their partnership, and building a brand new model of medical alliance between a hospital and a local government. Also presented are characteristics of such a model, and analysis of operational data in benefiting the people. They held that such a partnership is a worthy attempt in the healthcare reform, by means of building medical alliances between local government and provincial hospitals. Such a practice can provide valuable references for promoting government-hospital synergy, elevating primary healthcare capacity and advancing the hierarchical medical system. Key words: Government; Hospital, public; Medical alliance; Hierarchical medical system; Fujian province