Ramelan Surabaya Research Articles

Pengaruh Penerapan Aplikasi Sakti dan Kompetensi SDM terhadap Kualitas Penyajian Data Keuangan LAKIP TA 2023 di RSPAL dr. Ramelan Surabaya

This research is aimed at determining the impact of the application of reasonable applications and human resources competencies on the quality of presentation of financial data in LAKIP Year 2023 at RSPAL Dr. Ramelan Surabaya. This research uses quantitative methods on populations that include administrative, financial, program, and budget staff, the drafting team, and users of financial reports for LAKIB Year 2023. Simple random sampling technique or stratification of samplings of 39 people. Data collection technique using a Likert scale questionnaire. Data analysis techniques using decryptive statistics and inferential statistics with the help of SPSS software version 27. The results of this study found that the implementation of accurate applications has a positive and significant impact on the quality of presentation of financial data in LAKIP year 2023 of 79.2%. Human resources competence has a positive and significant impact on the quality of presentation of financial data in LAKIP year 2023 by 77.1%. Applying of Sakti application and human resources competence combined have a positive impact and significant influence on the presentation quality of financial information LAKIB year 20–23 by 80.5%. Furthermore, the remaining 19.5% is another variable contribution that the researchers have not observed thoroughly in this research.

Effectiveness of educational methods of lectures and lectures with leaflet regarding husband's knowledge about postpartum care at Naval Central hospital dr. Ramelan Surabaya

Introduction: The postpartum period is critical in the survival of the mother and newborn. Most maternal and newborn deaths occur within the first month after delivery. Mothers and newborns need health care during this period to avoid the risk of illness and death. The importance of the husband's contribution to postpartum care is greatly influenced by the husband's knowledge about postpartum care. Objective: This research aims to determine the effectiveness of providing education through lecture and lecture methods with leaflets to increase husbands' knowledge about postpartum care. Method: This research is a type of quasi-experimental research. The research design uses a pre-posttest one-group design with questions about the husband's knowledge about the time of delivery. Sampling techniques are consecutive sampling, with 15 people in the lecture group and 15 people in the lecture group with leaflets. Data is collected using questionnaires. Statistical tests are used using the Wilcoxon signed test and Mann Whitney test. Result: A significant majority (65.7%) of the sampled toddlers were diagnosed. The research results showed that the average knowledge of respondents about postpartum care before being given health education using leaflet lectures was 61.4, and after being given health education was 74.2. Meanwhile, the results of the lecture method with leaflets showed that the average knowledge of respondents about early marriage before being given education was 61.2, and after education, using the lecture method with leaflets increased to 78.6. By testing Mann Whitney, the significance obtained was 0.023<0.05, so it can be concluded that there is a significant difference between the lecture method and lecture method with leaflet. Conclusion: Lecture education using leaflets is more effective than the lecture method in increasing husbands' knowledge about postpartum care at Naval Central Hospital dr. Ramelan Surabaya.

NURSING CARE ANALYSIS OF ARTIFICIAL RESPIRATORY MANAGEMENT IN STROKE-ASSOCIATED PNEUMONIA (SAP) PATIENTS: A CASE STUDY FROM ICU RSPAL DR. RAMELAN SURABAYA

Introduction: Stroke-associated pneumonia (SAP) is a common complication of stroke, leading to ineffective airway clearance and potentially severe outcomes such as respiratory failure and death. Objective: This case study analyzes the nursing care provided to a SAP patient in the ICU of RSPAL Dr. Ramelan Surabaya, focusing on the application of artificial respiratory management to improve airway clearance Methods: Over five days, the nursing team implemented interventions, including Endotracheal Tube (ETT) care, which partially resolved the ineffective airway clearance. Results: This improvement was evident in the enhanced respiratory parameters and reduced secretion accumulation. Conclusions: The findings highlight the importance of diligent airway management in preventing respiratory complications in SAP patients.

The Correlation between Leukopenia and the Severity of Dengue Hemorrhagic Fever in Pediatric Patients

The aim of this study is to investigate the correlation between leukopenia and the severity of DHF in pediatric patients treated at RSPAL dr. Ramelan Surabaya from January 2021 to December 2022. This analytical observational study employed a cross-sectional design, involving 126 patient records from RSPAL dr. Ramelan Surabaya during the specified period. The sample selection was done using purposive sampling. The variables under investigation were leukopenia on days 2 to 5 and the DHF grade in patients aged 5 to 14 years. The statistical correlation test, Kendall's tau-b, indicated that there is no significant correlation between leukopenia and the severity of DHF in pediatric patients, with a p-value of 0.340, meaning p > α (with α = 0.05). The data revealed that out of the patients, 88 (69.8%) had Grade I, 16 (12.7%) had Grade II, 19 (15.1%) had Grade III, and 3 (2.4%) had Grade IV. Leukopenia occurred in 49 (73.1%) Grade I patients, 9 (13.4%) Grade II patients, 7 (10.4%) Grade III patients, and 2 (3%) Grade IV patients. In conclusion, this study found no significant correlation between leukopenia and the severity of DHF in pediatric patients treated at RSPAL dr. Ramelan Surabaya from January 2021 to December 2022.

Analisis Kelengkapan Kuantitatif Berkas Resume Medis di Rumah Sakit Angkatan Laut Dr. Ramelan Surabaya

A complete medical record form is an indicator of good medical record management and directly affects service quality. Analysis of the completeness of medical record files at Dr. Ramelan Surabaya found that the completeness of the medical resume had not reached 100%, only 90% completeness. The purpose of this study was to analyze the completeness of medical resume files at Dr. Ramelan Surabaya with descriptive method. Data collection used the cross sectional method in September 2022 as many as 21 medical resume forms. The results showed that the identification review obtained 100% complete in filling out medical resumes. Completion of medical resumes on critical report reviews is at least 19% on treatment while being treated. Authentication review is only 76% for filling in the patient's full name. Review the documentation that is correct, the blank part is 19%. The conclusion of this study is the highest incompleteness in the treatment while being treated by 81% in the review of important reports, so filling out the medical record file at RSPAL Dr. Ramelan is said to be still incomplete.

Description Competencies of Medical Surgical Nursing Preceptors at Naval Center Hospital Dr. Ramelan Surabaya, Indonesia

This study evaluated the competence of preceptors in surgical medical nursing. The research method uses quantitative descriptive with a cross-sectional research design. The sample number was 100 respondents doing clinical practice in medical-surgical nursing at the Navy Central Hospital. Dr. Ramelan Surabaya. The sampling technique uses Simple Random Sampling. The questionnaire used is the Preceptor Competency Questionnaire, which is a self-assessment. The results showed that all preceptors had good competence in all indicators. These indicators include knowledge competence, clinical skills, teaching ability, communication skills, personal characteristics, leadership, professional behavior, and ethics. However, a small percentage of receptors need to improve the ease of consultation. This research provides new insights into the practice of clinical guidance in surgical medical nursing. It can be applied to enhance the quality of clinical learning in hospitals and nursing education institutions.

The Effect of Hyperbaric Oxygen Therapy on Reducing Blood Cortisol Levels in Individuals with Anxiety Disorders

This research pertains to developmental advancements in the health and maritime sectors, specifically focusing on diving and hyperbaric oxygen therapy's (HBO) application. The study holds the potential to enhance comprehension regarding the Effects of Hyperbaric Oxygen Therapy (HBO) in addressing anxiety disorders, thus contributing significantly to the realms of health and maritime industries. Hyperbaric oxygen therapy involves subjecting patients to heightened pressure environments while administering pure oxygen at levels exceeding atmospheric pressure, with a minimum clinical threshold of 1.4 ATA. (HBO) interventions, utilized for countering hypoxia and cortisol reduction, exhibit promise in mitigating anxiety disorders. The research methodology commences with a systematic screening procedure employing an anxiety disorders questionnaire, ensuring the acquisition of a well-defined, credible, consistent, and unbiased participant pool. Employing a quasi-experimental design featuring a randomized pre-post control group arrangement, the study targets males aged 25-40 with anxiety disorders, drawn from Dr. Ramelan Surabaya's psychiatric clinic.

UJI EFEKTIVITAS DAN KEAMANAN KOMBINASI METFORMIN-VILDAGLIPTIN PADA DIABETES MELITUS TIPE 2 DI RSPAL Dr. RAMELAN SURABAYA

Metformin is the first-line therapy for Diabetes Mellitus (DM), which has not been able to control blood glucose in type 2 DM. One of the Dipeptidyl Peptidase IV Inhibitor (DPP4-I) groups, namely vildagliptin, has been included in the National Formulary which is used as a combination for the therapy of DM patients Type 2. Research objectives to know the effectiveness and safety of the combination of metformin-vildagliptin in type 2 DM at RSPAL Dr. Ramelan Surabaya. This research method uses a quantitative method with an observational study design, with retrospective data collection based on the Medical Records of Type 2 DM patients who first received metformin-vildagliptin combination therapy (n = 30) carried out observations, and recorded the results of Fasting Blood Glucose (GDP) examinations, Postprandial 2-hour blood glucose (GD2JPP), and HbA1C at baseline and after 3 months of therapy, and observed the safety of the combination. Results The metformin-vildagliptin combination reduced GDP 33.13 ± 40.73 mg/dL, GD2JPP 34.30 ± 48.81 mg/dL, and HbA1C 0.89 ± 0.86%. Did not show any side effects of hypoglycemia, but 3.33% experienced nausea/vomiting and dyspepsia. It was concluded that the combination of metformin-vildagliptin was able to reduce GDP, GD2JPP, and HbA1C.

The Combination of Treatment for Glaucoma

Glaucoma is the leading cause of permanent vision loss worldwide. Because the disease may be asymptomatic until an advanced stage, diagnosis is often delayed.1 An estimated 57.5 million people worldwide develop primary open-angle glaucoma (POAG). The purpose of this study was to determine the comparison of intraocular pressure reduction in open-angle primary glaucoma patients between monotherapy, double therapy, and triple combination therapy. This study is a type of observational analytical research with a cross sectional approach. Which is a research design in which data collection of both independent and dependent variables and factors that influence them are collected at the same time. The research was conducted at the Eye Clinic of RSPAL dr. Ramelan Surabaya. The population taken was a 53-year-old female patient diagnosed with open-angle primary glaucoma at the Eye Clinic of RSPAL dr. Ramelan Surabaya. The results showed that trabeculectomy had a statistically significant result that was very high on IOP reduction and decrease in the number of antiglaucoma drops. Untreated glaucoma can lead to permanent vision loss or blindness that occurs more quickly. The earlier treatment is given, the more vision loss can be delayed or reduced.

Hyperbaric Oxygen Therapy as Adjuvant Therapy in Nasopharyngeal Cancer : A Literature Review

Introduction
 Hyperbaric oxygen therapy (HBOT) may not be widely known. In Indonesia itself, the HBOT application was first carried out in 1960 by the Indonesian Navy Marine Health Institute / Lembaga Kesehatan Kelautan TNI AL (Lakesla) in collaboration with the Naval Central Hospital (Rumah Sakit Pusat Angkatan Laut / RSPAL) Dr. Ramelan Surabaya, where until now the facility is still the largest in Indonesia. Hyperbaric oxygen therapy was first introduced by Behnke in 1930. At that time hyperbaric oxygen therapy was only given to divers to relieve symptoms of decompression sickness (Caisson's Disease)1. Hyperbaric oxygen therapy is a treatment method using high pressure oxygen, where the pressure used is higher than atmospheric pressure (more than 1 atm). High pressure oxygen therapy methods are currently widely used as adjuvant therapy for various pathological conditions associated with hypoxic and/or ischemic conditions. The standard procedure for HBOT is to inhale pure oxygen (100% O2) using a pressure between 1.5 and 2.5 atmospheres absolute (ATA) by mask or by endotracheal tube which is the sum of the atmospheric pressure and the gauge pressure in a hyperbaric chamber2–4.

Diagnostic Test Fine Needle Aspiration Biopsy (FNAB) Examination on Gold Standard Histopathological Tests for Identification of Colli Lymphadenopathy Patients at RSPAL. Dr. Ramelan Surabaya

Lymphadenopathy is a common clinical manifestation which requires rapid and accurate diagnosis. Fine Needle Aspiration Biopsy (FNAB) is used as an initial and direct diagnosis in cases of lymphadenopathy, confirmatory diagnosis of colli lymphadenopathy is carried out by histopathological examination. The purpose of this study was to determine the value of the FNAB diagnostic test for lymphadenopathy colli FNAB against the gold standard histopathology of Paraffin Blok for benign and malignant lymphadenopathy, examination data for Colli Lymphadenopathy obtained at RSPAL has never been studied before. This type of research is observational descriptive by taking medical record data (SIM-RS) of patients with lymphadenopathy in the colli region who were examined for FNAB and histopathology at the Anatomical Pathology Laboratory Installation, RSPAL dr. Ramelan Surabaya for the period January 2019 – March 2022. The sample used was selected using the total sampling method, obtained as many as 66 samples that met the inclusion criteria. The results of the FNAB examination were then matched against the histopathological gold standard examination data. Furthermore, the data was processed by 2x2 crosstabulation and diagnostic tests were carried out to determine the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. The results showed that the accuracy of the FNAB diagnostic test was 86.56%, sensitivity 80.48%, specificity 96.15%, positive predictive value 97.05%, negative predictive value 75.75%. In general, it can be stated that the FNAB examination can be a screening diagnostic tool that is easy, fast, relatively affordable and applicable in helping to establish the diagnosis of colli lymphadenopathy.

Perbedaan Manifestasi Klinis Kejang Demam Pada Anak Anemia dengan Tanpa Anemia di RSPAL dr. Ramelan Surabaya Tahun 2019-2022

Study aims: Febrile seizures are the most common neurological disorder in children. The incidence of febrile seizures is related to the incidence of epilepsy at 2-4% in the future and the probability of recurrence is about 30% and 50% after the first and second febrile seizures, respectively. Several recent studies have suggested that febrile seizures are more common in children with anemia. Anemia patients who experience febrile seizures can cause more severe clinical manifestations. Where 40.5% of the incidence of anemia in Indonesia occurs in children under the age of 5 years. Therefore, this study is conducted to determine the differences of the clinical manifestations of febrile seizures with and without anemia in children at RSPAL Dr. Ramelan Surabaya on 2019-2022.
 Methods: This study was an observational analytic study with a cross-sectional study approach and qualitative methods from secondary medical record data of infants and children aged 6 months-5 years at RSPAL Dr. Ramelan Surabaya for the period May 2019-May 2022. The number of samples in this study was 82 samples.
 Results: The characteristics of the sample which experiences the most febrile seizures occurres between the ages of 6-18 months, the gender of male with a temperature >38°C and manifestations in the form of simple febrile seizures. In addition, the results of the fisher exact test with a significance level of 5% shows p = 0.96 which means there is no difference in the clinical manifestations of febrile seizures in anemic and non-anemic children.
 Conclusion: The conclusion of this study is that based on the classification of febrile seizures, the most common clinical manifestations that occur in children with anemia and without anemia are simple febrile seizures. So that there is no difference in the clinical manifestations of febrile seizures in anemic children and without anemia.

Outcome Terapi Covid-19 pada Pasien yang Mendapatkan Antikoagulan Profilaksis di RSPAL Dr. Ramelan Surabaya

Complications of thrombotic and hemorrhagic coagulation often occur in Covid-19 patients, so it is advisable to provide anticoagulant therapy, accompanied by monitoring of parameters of coagulation abnormalities, including D-Dimer. This study aims to determine the outcome of therapy for Covid-19 in patients with anticoagulant prophylaxis use in RSPAL Dr. Ramelan Surabaya. This study is a retrospective descriptive study based on medical records of Covid-19 patients from June-August 2021. The sample in this study was subjects aged >18 years who were confirmed positive for Covid-19 based on RT-PCR, with comorbid or without comorbidities, and received anticoagulant therapy. Then, this study did not include subjects who were pregnant or with malignancy/acute conditions. From 134 research samples, it was found that the use of anticoagulants using a single anticoagulant (n=131, 97.76%) was more widely used, with the most frequently used types being enoxaparin (n=68, 50.75%), and heparin (n=48, 35,8%). In conclusion, the recovery percentage in Covid-19 subjects with anticoagulant therapy was 77.61%, and the percentage of mortality was 22,39%.

Analysis of Images of Neutrophil Lymphocyte Ratio and Bacteria Density Level of Helicobacter Pylori in Tissue in Gastritis Patients

Gastritis is an inflammatory disease that can last for a long time. Helicobacter pylori infection is known as the main cause of peptic ulcer and the most common cause of gastritis. Helicobacter Pylori infection will cause mononuclear (MN) and polymorphonuclear (PMN) cell infiltration and will increase the production of proinflammatory cytokines in the gastric mucosa compared to non-Helicobacter Pylori gastritis. Helicobacter Pylori with histopathological examination diagnosis. This type of research is descriptive observational with purposive sampling data collection technique at the Anatomical Pathology Laboratory Installation, RSPAL dr. Ramelan Surabaya. The data used are the results of a biopsy of 60 samples that were determined as gastritis with histopathological examination of the identification of Helicobacter Pylori bacteria in gastric tissue classified by the level of bacterial density using The Updated Sydney System, as well as haemogram data for complete blood examination to further calculate the neutrophil lymphocyte ratio (NLR). The data were processed using descriptive statistical tests to determine the average neutrophil lymphocyte ratio (NLR). Based on the statistics of the r-Spearman test, the density of Helicobacter Pylori, (Pν = 0.000) below < 0.005 indicates that there is a strong relationship between the neutrophil lymphocyte ratio (NLR) and the density of Helicobacter Pylori bacteria.

Hubungan Status Gizi Pasien Penyakit Hirschsprung dengan Infeksi Luka Operasi di RSPAL dr. Ramelan Surabaya Periode Waktu 2016-2020

Background: Hirschsprung's disease is a congenital intestinal motility disorder that causes functional intestinal obstruction due to the absence of enteric ganglion cells in the distal intestine. The management of each case of Hirschsprung's disease is surgery, where surgery on the digestive tract increases the occurrence of surgical site infections. Disturbances in the gut cause decreased resistance to infection, delayed cognitive development, and problems with nutritional status.
 Methods: This study was a descriptive and analytical observational study, where the primary data were taken from the registration data of Hirschprung's disease patients at RSPAL dr. Ramelan Surabaya in 2016-2020. The nutritional status of the patient was determined by plotting the weight per age curve according to WHO for children aged 0-5 years.
 Results: Observations of 38 patients who met the study requirements, obtained 4 patients who had poor nutritional status and 1 patient who had excess nutritional status, none of which experienced complications in the form of surgical wound infections. In 10 patients with poor nutritional status, 2 experienced complications in the form of surgical wound infection and 23 patients with good nutritional status, 1 experienced complications in the form of surgical wound infection. The results of the contingency coefficient correlation test showed P-value = 0.408 (p>α).
 Conclusion: There was no relationship between the nutritional status of Hirschprung's disease patients with surgical wound infections at RSPAL dr. Ramelan Surabaya
 Keywords: Hirschsprung's disease, nutritional status of children, surgical site infection.

PERBEDAAN KADAR HEMOGLOBIN DAN INDEKS ERITROSIT PADA PASIEN GAGAL GINJAL KRONIK PRE DAN POST HEMODIALISIS DI RSPAL Dr. RAMELAN SURABAYA

Chronic Kidney Disease can cause a progressive decline in kidney function which can lead to kidney failure. One of the therapies for patients with chronic kidney failure is hemodialysis, but this method can cause complications, including worsening of anemia. This study aims to determine differences in hemoglobin levels and erythrocyte index in patients with chronic renal failure before and after hemodialysis. This study is an experimental using data on hemoglobin and erythrocyte index results pre and post hemodialysis in patients with chronic kidney failure undergoing hemodialysis therapy at RSPAL dr. Ramelan Surabaya. Paired Sample T-test was used to determine differences in hemoglobin levels and erythrocyte index in patients with chronic renal failure pre and post hemodialysis. In this study, there were differences in hemoglobin levels and erythrocyte index in patients with chronic renal failure before and after hemodialysis.

Policy Implementation of Social Security Providering Agency in Serving Outpatient Patients in Oncology Poly Rspal Dr. Ramelan Surabaya

It is increasingly difficult for the community to obtain health services due to the high cost of health care. In 2020 cancer treatment has absorbed BPJS funds of 3.1 trillion rupiah. The high number of breast cancer (Carcinoma Mammaee) in Indonesia is a priority for the Government. With this, the Government strengthens medical services for the treatment of breast cancer patients, by regulating the distribution of health services for cancer patients to make it easier for patients to access adequate health services. In 2021 RSAL Dr. Ramelan Surabaya received a certificate of appreciation from BPJS Health for his real commitment and contribution in providing the best service for JKN-KIS participants in the category A class A Hospital Surabaya branch. Thus, researchers want to know more about how the implementation of the policies of the Social Security Administering Agency (BPJS) in serving outpatients at the Oncology Poly RSPAL Dr. Ramelan Surabaya as a plenary type A hospital. Using the theory of policy implementation according to George Edward III (1980), with the variables of communication, resources, disposition, and organizational structure. By using qualitative research methods and data collection techniques interview, observation, and documentation. Although there are obstacles in implementing the BPJS program at RSAL Dr. Ramelan, but this can be handled well by the efforts made by RSPAL Dr. Ramelan. It is recommended that in the implementation in the field more strengthening of health workers either directly or indirectly. Comprehensive socialization in every part of the hospital from the bottom to the top RSPAL Dr. Ramelan starts from written or unwritten policies. Facilitate the use of BPJS for new breast cancer patients seeking treatment.

Policy Implementation of Social Security Providering Agency in Serving Outpatient Patients in Oncology Poly Rspal Dr. Ramelan Surabaya

Policy Implementation of Social Security Providering Agency in Serving Outpatient Patients in Oncology Poly Rspal Dr. Ramelan Surabaya

CORRELATION OF THE USE OF CONTRACEPTIVE PILL COMBINATION TO RISK OF LEIOMYOMA EVENTS IN RSPAL SURABAYA

The use of contraception is important to control population growth, regulate the interval between pregnancies, avoid unwanted births, control the time of birth in a husband and wife relationship and determine the number of children in the family. According to the Central Statistics Agency (BPS) of East Java Province in 2018, the number of active Family Planning (KB) participants of married women of childbearing age who use hormonal contraception in the form of pills was 19.26%, injections were 50.44%, and implants is 11. 45%. Uterine fibroids occur in 20%-25% of women of reproductive age. The prevalence of leiomyoma may increase with hormonal contraceptives containing the hormone estrogen, either pure or combined. Uterine fibroids can affect the quality of life of the sufferer. Purpose: To analyze the relationship between the use of combined pill contraceptives and those who do not use the combined pill contraception in women with the incidence of leiomyoma. Method: This research is an observational analytic carried out retrospectively with a case-control approach. The sampling technique in this study was non-probability sampling, namely purposive sampling. This study uses secondary data, namely medical records of gynecological patients at the RSPAL Dr. Ramelan Surabaya by meeting the inclusion criteria and exclusion criteria. The data collected will be analyzed by looking at whether leiomyoma patients use combined pill contraception. Result: Patients diagnosed with leiomyoma who used the combined pill contraceptive were 48 (63%), while those who did not use the combined pill were 28 (37%). This study's results indicate a significant relationship between the use of combined pill contraceptives and the incidence of leiomyoma (p=0.001). Conclusion: There is a relationship between the use of combined pill contraceptives with the incidence of leiomyoma.

THE RISK FACTORS FOR THE HYPERBILIRUBINEMIA INCIDENT IN NEONATES AT DR. RAMELAN HOSPITAL IN SURABAYA

condition that often occurs in neonates. This condition is important to note, because if the bilirubin levels are too high, it can lead to several complications in the brain, such as encephalopathy and cerebral palsy in infants.Objective: The objective of this study is to analyze which maternal and neonatal risk factors can cause hyperbilirubinemia in neonates. Methods: This study is an analytical study with a cross sectional approach. Population samples was taken from the perinatology room Dr. Rumkital. Ramelan Surabaya in January 2018 - December 2019, there were 252 samples and 122 samples who experienced hyperbilirubinemia. Data analysis using Chi Square test and logistic regression. Results: It was found that the type of delivery with cesarean section was the largest percentage with a p value of 0.106;; Most LBW with p value 0.038; male at most with a p value of 0.046. From the results of multivariate analysis, it was found that the variable birth weight had a greater influence on the incidence of hyperbilirubinemia compared to other variables with a significance value of p value 0.00 on alpha 5%. Conclusion: There is a significant relationship between type of gestational age, sex and birth weight with the incidence of hyperbilirubinemia, while the type of delivery and parity have no significant relationship with the incidence of hyperbilirubinemiia. Keywords: Hyperbilirubinemia, Neonates, Risk Factor