Regional Public Hospital Research Articles

Analisis Sistem Pelayanan Administrasi salam Penerimaan Pasien BPJS Di Ruang Instalasi Gawat Darurat Rumah Sakit Umum Daerah Datu Pancaitana Kabupaten Bone

The implementation of management system in health services is common as an attempt to improve the quality. In Indonesia, the most commonly used health insurance is the service issued by Badan Penyelenggara Jaminan Social or BPJS (Social Security Administration) that collaborates with many hospitals such as Datu Pancaitana Regional Public Hospital in Bone Regency. This research uses qualitative approach with a case study as the research design. The research data are obtained through in-depth interviews with The Head of Medical Records Department, some staffs of the administrative service as well as patients of BPJS users in the Emergency Unit. In addition to that, this research collects its research data through field observations and a review of related previous studies. The findings reveal that the hospital management applies the following strategies in the division of administrative services: (1) planning through trainings and workshops provided for the human resources as well as the formulation of RUK and RPK; (2) organising through trainings involving a number of institutions within Datu Pancaitana Regional Public Hospital in Bone Regency; (3) actuating through an execution of administrative services for BPJS users; (4) controlling through supervision facilitated by the hospital management; (5) evaluating that addresses the process of human resources quality promotion through databased information trainings. In conclusion, the findings of this research are hoped to provide insights that can be useful for the hospital management specifically the emergency unit to improve their performance in providing services for BPJS users. They can start by assessing the development and training, program execution and evaluation aspects as well as by improving the facilities and infrastructure.

Gambaran Faktor Risiko Kejadian Abortus Spontan pada Ibu Hamil di RSUD Panembahan Senopati Bantul Tahun 2017-2018

Abortion is the release of fetus in the uterus before 20 weeks or less than 5 months of pregnancy and the fetus weights less than 500 gram. In addition, the fetus still cannot live outside the uterus. The risky factors of abortion are mother’s age, parity, previous abortion history, education, occupation, and the distance of pregnancy with the previous pregnancy. The study is to investigate the frequency distribution of risk factors of spontaneous abortion of pregnant women at Panembahan Senopati Regional Public Hospital of Panembahan Senopati Bantul in 2017 – 2018. The study was analytic in type. The population of the study was 60 pregnant women. The samples of the study were 54 pregnant women. The samples were taken using total population. The analysis method was univariat analysis to reveal frequency distribution. The study revealed that 54 people experienced spontaneous abortion and 40 people (74.1%) experienced imminens abortion and 14 people (25.9%) experienced incompletes abortion. The risk factors of spontaneous abortion based on univariat analysis were non-risky age, safe parity 91, 2, and 3), non - spontaneous abortion history, non- anemic condition, educational level of senior high school, working status, and more than 2 years of pregnancy distance. It is suggested that health officers perform midwifery care on pregnant women experiencing spontaneous abortion.

Evaluasi Pola Peresepan Pasien Geriatri di RSUD Dr. Soedarso Pontianak Berdasarkan Beers Criteria

Geriatric patients are suffering from multiple diseases and disorders due to decreased physiological function. The prescription of polypharmacy in this condition can increase the risk of adverse events. Beers Criteria is often used as a reference to identify the risk in geriatric medications. Therefore, this study aimed to obtain an overview of prescriptions with the percentage of usage based on Beers Criteria 2012. A descriptive and observational design was used with a cross-sectional approach. A total of 150 medical records and prescriptions of geriatric outpatients were obtained using a simple random sampling technique at Dr. Soedarso Regional Public Hospital Pontianak, from December 2018 to July 2019. Demographic-characteristic data of patients and class of therapy were identified from medical records and prescriptions. The data were analyzed with a quantitative approach to determine the percentage of patients receiving medications and the percentage of medications based on Beers Criteria 2012. The percentage of polypharmacy based on prescriptions was 21.33%, while 36% received the treatments, which met the criteria. Among the 150 prescriptions that met Beers Criteria, 15 were Spironolactone, which the most frequent therapy. Based on the results, geriatric patients still received medications that met Beers Criteria. It is also very important to carry out safety monitoring when drugs are used by infected people.

Sharia Service as An Added Value: Response to Sharia Standard in Hospital Service

The application of sharia principles in business activities and services adds to standard compliance and some of them are trapped in the legalistic formality aspect rather than improving business ethics. In hospitals, which main business is providing health services, applying sharia principles may enhance the added value in health services or just a formal aspect. The purpose of this study seeks to reveal the community's response to the application of sharia standards in hospitals. The study used a quantitative research method, through the distribution of questionnaires to 50 patients and their families in three regional public hospitals; Zainoel Abidin Hospital Aceh, Sultan Agung Hospital Semarang, and Bandung Islamic Hospital, and interviews with the management and sharia supervisory board of the hospital. This study describes descriptively, with a Likert scale approach, to see the response toward the application of sharia standards. The results show that the majority of respondents gave a positive response to the application of sharia standards. Sharia standards are added value services in sharia hospitals. The results of this study is implicated in the management of sharia compliance in hospitals and the need for regulatory support for the implementation of sharia in hospitals.

Coping mechanism with anxiety levels in chronic kidney disease patients undergoing hemodialysis at Toto Kabila Hospital

Chronic kidney disease is a progressive and irreversible renal disorder in which the body fails to maintain metabolism, balance, and electrolytes. Patients with such a disease should undergo regular hemodialysis therapy, leading to physical and psychological problems, i.e., anxiety. Inappropriately treated anxiety will cause the patients to not stick to the dietary pattern, hemodialysis, and infantilism. They need to strive to deal with their problems, known as a coping mechanism. The purpose of this study was to determine the correlation between coping mechanisms and anxiety levels of patients with chronic kidney disease that underwent hemodialysis at Toto Kabila Regional Public Hospital. It relied on a quantitative method with the cross-sectional approach. A total of 30 respondents were taken as the sample using the purposive sampling technique. Moreover, the Somers’D test with a questionnaire instrument was applied to analyze the data. It was shown that coping mechanisms correlated with anxiety levels of patients with chronic kidney disease who underwent hemodialysis therapy (p-Value = 0.005) in the site area.

Implementation of nursing independent functions in pain management in the Kenanga room of RSUD Dr. H. Soewondo Kendal

Independent function of nursing is an independent action that does not require instructions from others (such as doctors), where nurses in carrying out their duties are carried out on their own with their own decisions based on nursing knowledge to meet basic human needs. Many studies on independent nursing actions have been carried out. The research used yo determine the implementation of an independent nursing function in pain management in the Kenanga Room of Regional Public Hospital Dr. H. Soewondo Kendal. This type of research uses descriptive design. The sampling technique uses total sampling. The samples used are 21 respondents. The place of research was conducted in the Kenanga Room of Regional Public Hospital Dr. H. Soewondo Kendal. This research uses the type of instrument in the form of observation sheets. Results shows that the implementation of the independent function of pain management nursing performed in the Kenanga Room of Regional Public Hospital Dr. H. Soewondo Kendal, namely the management of pain breathing techniques in 66.7%, dhikr therapy 23.8%, warm compresses 4.8%, and pharmacology 71.4%. Analysis: Pain management performed includes pharmacology, deep breathing relaxation, khafi dhikr, and warm compresses.

Effectiveness of crisis resolution home treatment for the management of acute psychiatric crises in Southern Switzerland: a natural experiment based on geography

BackgroundCrisis Resolution Home Treatment (CRHT) is an alternative to inpatient treatment for acute psychiatric crises management. However, evidence on CRHT effectiveness is still limited. In the Canton of Ticino (Southern Switzerland), in 2016 the regional public psychiatric hospital replaced one acute ward with a CRHT. The current study was designed within this evaluation setting to assess the effectiveness of CRHT compared to standard inpatient treatment.MethodsCRHT was offered to patients aged 18 to 65 with an acute psychiatric crisis that would have required hospitalization. We used a natural experiment based on geography, where intervention and control groups were formed according to the place of residence. Primary endpoints were reduction of psychiatric symptoms at discharge measured using the Health of the Nation Outcome Scales, treatment duration in days, and rate and length of readmissions during a two-year follow-up period after discharge. Safety during the treatment period was measured with the number of serious adverse events (suicide/suicide attempts, major self-harm episodes, acute alcohol/drug intoxications, aggressions to caregivers or family members). We used linear, log-linear and logistic regression models with propensity scores for the main analysis.ResultsWe enrolled 321 patients; 67 were excluded because the treatment period was too short and 17 because they were transferred before the end of the treatment. Two hundred thirty-seven patients were available for data analysis, 93 in the intervention group and 144 in the control group. No serious adverse event was observed during the treatment period in both groups. Reduction of psychiatric symptoms at discharge (p-value = 0.359), readmission rates (p-value = 0.563) and length of readmissions (p-value = 0.770) during the two-year follow-up period did not differ significantly between the two groups. Treatment duration was significantly higher in the treatment group (+ 29.6% on average, p-value = 0.002).ConclusionsCRHT was comparable to standard hospitalization in terms of psychiatric symptoms reduction, readmission rates and length of readmissions, but it was also characterized by a longer first treatment period. However, observational evidence following the study indicated that CRHT duration constantly lowered over time since its introduction in 2016 and became comparable to hospitalization, showing therefore to be an effective alternative also in terms of treatment length.Trial registrationISRCTN38472626 (17/11/2020, retrospectively registered).

Point-prevalence survey of antibiotic use at three public referral hospitals in Kenya.

Antimicrobial stewardship encourages appropriate antibiotic use, the specific activities of which will vary by institutional context. We investigated regional variation in antibiotic use by surveying three regional public hospitals in Kenya. Hospital-level data for antimicrobial stewardship activities, infection prevention and control, and laboratory diagnostic capacities were collected from hospital administrators, heads of infection prevention and control units, and laboratory directors, respectively. Patient-level antibiotic use data were abstracted from medical records using a modified World Health Organization point-prevalence survey form. Altogether, 1,071 consenting patients were surveyed at Kenyatta National Hospital (KNH, n = 579), Coast Provincial General Hospital (CPGH, n = 229) and Moi Teaching and Referral Hospital (MTRH, n = 263). The majority (67%, 722/1071) were ≥18 years and 53% (563/1071) were female. Forty-six percent (46%, 489/1071) were receiving at least one antibiotic. Antibiotic use was higher among children <5 years (70%, 150/224) than among other age groups (40%, 339/847; P < 0.001). Critical care (82%, 14/17 patients) and pediatric wards (59%, 155/265) had the highest proportion of antibiotic users. Amoxicillin/clavulanate was the most frequently used antibiotic at KNH (17%, 64/383 antibiotic doses), and ceftriaxone was most used at CPGH (29%, 55/189) and MTRH (31%, 57/184). Forty-three percent (326/756) of all antibiotic prescriptions had at least one missed dose recorded. Forty-six percent (204/489) of patients on antibiotics had a specific infectious disease diagnosis, of which 18% (37/204) had soft-tissue infections, 17% (35/204) had clinical sepsis, 15% (31/204) had pneumonia, 13% (27/204) had central nervous system infections and 10% (20/204) had obstetric or gynecological infections. Of these, 27% (56/204) had bacterial culture tests ordered, with culture results available for 68% (38/56) of tests. Missed antibiotic doses, low use of specimen cultures to guide therapy, high rates of antibiotic use, particularly in the pediatric and surgical population, and preference for broad-spectrum antibiotics suggest antibiotic use in these tertiary care hospitals is not optimal. Antimicrobial stewardship programs, policies, and guidelines should be tailored to address these areas.

Promoting a Culture of Safety in Cholecystectomy (COSIC) over a decade at a Philippine public regional hospital after the SAGES International Proctoring Course in Laparoscopic Cholecystectomy Course.

The SAGES International Proctoring Course for Laparoscopic Cholecystecomy accepts applications from low to middle-income countries for SAGES faculty to train local surgeons. A regional public hospital in the 10th most populous city in the Philippines was one of the chosen sites for the 1-week course in 2010. Two SAGES surgeons and one nurse trained two local surgeons and four nurses identified by the hospital director. All patients seen in the out-patient clinic at the Zamboanga City Medical Center in the Philippines and scheduled for elective laparoscopic cholecystectomy from the first day of the course in August 2010 until December 2018 were entered into a prospectively collected database including demographics, pre-op diagnosis, operative findings, histopathologic diagnosis, conversion rates and 30-day complications including re-operations. 521 patients underwent laparoscopic cholecystectomy. Majority were female (63.7%) with a mean age of 45.9years. Most procedures were completed laparoscopically with an open conversion rate of 3.3%. Three patients underwent laparoscopic subtotal cholecystectomy. Reported complications requiring reoperation included one stump necrosis, two incisional hernias and one retained stone. One serosal injury and one surgical site infection were also reported for an overall morbidity rate of 4.6%. Pathology showed chronic calculous cholecystitis in 92.8% of specimens. No 30-day mortality was recorded. The SAGES International Proctoring Course for Laparoscopic Cholecystectomy has been shown to be a successful method for global surgery training. A focused 1-week direct proctoring model in the Philippines showed a sustained culture of safety in cholecystectomy with low 30-day morbidity, complication and conversion rates over a decade following participation in this program.

The Effectiveness of Religious Therapy on the Psychological Condition of COVID-19 Patients in Isolation Treatment at a Regional Public Hospital in Indonesia

Religious therapy is a coping strategy that can be used to deal with stress. When patients are first diagnosed with COVID-19 they may feel anxious, shocked and sad, especially when it is stated that they need to undergo isolation treatment; it can feel as if all hope and happiness has been lost. Religious coping can be used to create spiritual happiness and psychological happiness, and may help minimize or even eliminate anxiety and depression that occurs in patients undergoing isolation treatment. This study aimed to evaluate the effectiveness of religious therapy on the psychological condition of COVID-19 patients undergoing isolation in hospital. This research used a quasi-experimental design involving a control group. The sample included 34 respondents (17 in each group). In the intervention group, religious therapy was given by reciting dhikr sentences and prayers for the sick. The dependent t test was used to analyze the data. The findings showed a significant difference in the anxiety and depression scores before vs. after the patients were given the religious therapy intervention (p-value &lt; 0.05 for both). Therefore, this study found that religious therapy can be effective in reducing anxiety and depression. The findings of this study could be used to provide an alternative recommendation in managing coping strategies to deal with stress among hospitalized patients.&#x0D; Keywords: anxiety, depression, religious therapy

The Influence of Emotional Labor, Positive Psychological, Capital, and Rewards on the Retention Intention among Coronavirus Disease 2019 Ward Nurses in Regional Public Hospitals

Purpose: The purpose of this study was to analyze the influence of emotional labor, positive psychological capital, and rewards on the retention intention among coronavirus diseases 19 (COVID-19) ward nurses in regional public hospitals. Methods: The subjects were nurses who directly participated in nursing while wearing protective gear (level D or higher) in a COVID-19 ward. Data were collected from March 15 to March 29, 2021, and a total of 187 questionnaires were analyzed. The data were analyzed with descriptive statistics, independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and multiple regression using SPSS for Windows version 27.0. Results: The mean scores of emotional labor, positive psychological capital, and retention intention were 3.48, 3.74, 3.22, and 5.75. The factors influencing retention intension were positive psychological capital (β=.28, p&lt;.001), and the explanatory power for retention intention was 20.0%. Conclusion: These results indicate that in order to increase retention intention, it is necessary to foster nurses with high positive psychological capital who can make good use of positive emotions, and additional research is needed to clarify the factors influencing nurses’s retention intention to remain in the organization.

The characteristics of overweight and obese COVID-19 inpatients at Kebayoran Lama regional public hospital

Coronavirus disease-2019/COVID-19 pandemic had affected globally. The growing prevalence of overweight and obesity globally have risen the concern on its additional impact to worsen this pandemic. Overweight and obesity have previously been shown to increase mortality and severity in patients with COVID-19. Based on those findings, we conducted a study at Kebayoran Lama Regional Public Hospital to provide real database regarding the characteristics of overweight and obese COVID-19 inpatients.

Nurses’ and patients’ perceptions on interruptions on admission processes at an acute public hospital using cross-sectional survey

ProblemAdmissions are a critical component of patient care. However, nurses get interrupted during care provision. There is limited understanding of the dynamics regarding interruptions during admission and their effect. AimTo ascertain how often and why interruptions occurred; and whether these impacted patients. MethodsThe cross-sectional survey study took place in the hospital of a 327-bed regional acute public hospital in Queensland, Australia, during July 2020. Nurses completed a survey asking about the admissions and interruptions they had encountered. Patients completed a survey asking about their perceptions of admissions and interruptions during the admission process. FindingsNurses across five units completed 171 surveys, and patients completed 55 surveys. There was no statistical difference in interruptions per hour between admissions of 15-44 min, 45 min to 1 h 15 min, and over 1 h 15 min. When the admissions with and without interruptions were compared, the ‘interrupted’ group had a median admission time of 50 min (interquartile range 35−75), and the ‘non-interrupted' group was 30 min (20-39) (p < 0.01). Nurses identified three themes of what could be improved to streamline admission processes: Simpler admission paperwork, admission timing and process, and emergency department input on admission documentation. Overall, patients were satisfied with the admission process. Patients' satisfaction was not impacted by the interruptions. ConclusionWhile nurses reported that admission processes were repetitive and could be simplified, patients were not concerned with the interruptions during admission in our study. However, future research with robust measures is required.

Planning and Budgeting of Medical Devices Among Ethiopian Public Hospitals.

BackgroundPlanning and budgeting of medical devices allow a healthcare institution to properly use funds, acquire quality and efficient medical devices, and improve healthcare service delivery. The lack of proper policy in the procurement and management of medical devices causes inappropriate usage of funds and impedes the quality of a product. This study aimed to identify the current practices and gaps in the planning and budgeting of medical devices in Ethiopian public hospitals. In this study, an assessment was conducted in all regional public hospitals to assess the current status of medical device management, identify the gaps, and provide suggestions for areas of improvement.MethodsA descriptive cross-sectional design was used for the study assessment where a structured data collection tool was utilized to collect data. A multi-stage stratified random sampling proportionate to size technique was employed for the sampling of public hospitals in all regions of Ethiopia. The collected data was analyzed using SPSS version 26 software.ResultsThe availability of medical equipment development plans, budgeting, and spare parts procurement plans were found to be below 50% in public hospitals. It was also noted that 40.3% of hospitals do not prepare medical device technical specifications during procurement orders. Moreover, the engagement of biomedical engineers/technicians in the planning and procurement of medical devices was found to be below 50%.ConclusionThis assessment showed that there is a need for improvement in the development of procurement plans and preparation of technical specifications for medical devices in Ethiopian public hospitals. Developing policies and strategies for the proper use of funds in the procurement of medical devices, involving biomedical engineering professionals in the planning, procurement and use of medical devices could help to improve the quality, optimized utilization and efficiency of medical devices and ultimately enhance healthcare service delivery.

The Effectiveness of Internal Audit in Regional Public Hospitals as Regional Public Service Agencies

Public hospitals as mandated by regulation, managed as a public service agency, which given the flexibility on financial and resources management to perform good business practices in order to improve community services. As a public enterprise, regional hospitals must conduct good corporate governance by optimizing resources and providing quality services. The internal audit function have important role in this area. The purpose of this study was to determine the effectiveness of the implementation of internal audit in regional public hospitals as public service agencies. The research method was descriptive with qualitative approach. Research data was collected by observation of documents and in-depth interviews in 2 hospital, regional public hospital in district and regional public hospital at Central Java Province. The research subjects consisted of directors, Internal Auditor Unit ( SPI), service department, , finance and general affair. Data was processed and then content analyzed. Based on the research, internal audit unit structure were just formed to fully regulations. The internal audit team were incompetent, no training, job descriptions of staff had not been detailed and auditor team was double job as additional task. Audit function was more focused on the compliance of financial aspects and accountability. The function of performance evaluation and compliance on regulations had not been carried out. The constraints are the limited number of personnel and double jobs. Hospital directors were usually immediately aware of problems that arise even without reports from the internal audit unit. Monitoring and evaluation of internal audit unit has not been carried out intensively. Internal audit function had not been effectively performed. It is need to appoint staff with appropriate competencies, the role and function of the internal audit unit have to be improved through the establishment of specific job descriptions and the granting of broader authority to audit in all units.

Gambaran Karekteristik Fraktur Radius Dital di RSUD Abdul Wahab Sjahranie Samarinda Tahun 2017-2019

Distal Radius Fractures are the most common fractures in the world. 17.5% of fractures are categorized as distal radius fractures. Distal radius fractures can occur in both young age and old age. Distal radius fractures mostly occur in young adult age group due to high-energy trauma, and in senior age group due to low-energy trauma and osteoporosis. This research aims to capture the overview of distal radius fracture characteristics at RSUD (Rumah Sakit Umum Daerah – Regional Public Hospital) Abdul Wahab Sjahranie Samarinda. The data in this research are secondary data, gathered from medical records of patients. This research was performed in February 2021. This research is a Descriptive Retrospective study. 146 patients diagnosed with distal radius fractures from January 2017 – December 2019 were selected as samples, using Total Sampling method. The result showed that most cases of distal radius fractures occurred in 10-19 years age group (29 patients, 19.9%), male (87 patients, 59.6%), students (47 patients, 34.2%). Furthermore, the most common type of fractures found was closed fracture type (137 patients, 93.8%), the most common clinical fracture found was unidentified fracture (65 patients, 44.5%), and the most common cause of fractures was from trauma (90 patients, 61.6%).

Budgeting for inventory of personal protection equipment in national health insurance patient services during the Covid-19 pandemic at Bahteramas regional public service agency hospital southeast Sulawesi Province, Indonesia

Budgeting for inventory of personal protection equipment in national health insurance patient services during the Covid-19 pandemic at Bahteramas regional public service agency hospital southeast Sulawesi Province, Indonesia

Storage and distribution of personal protective equipment in national health insurance patient services during the Covid-19 pandemic at Bahteramas regional public service agency hospital Southeast Sulawesi Province, Indonesia

The rate of transmission of the Covid-19 disease is very high so that it spreads very quickly throughout the world with very high morbidity and mortality rates. In an effort to handle Covid-19 at the Bahteramas Regional Public Service Agency (RPSA) Hospital, Southeast Sulawesi Province, it is necessary to have Personal Protective Equipment (PPE) for health workers to prevent cross-infection between patients and officers. The purpose of the study was to determine the storage and distribution of Personal Protective Equipment during the Covid-19 pandemic at the Bahteramas RPSA Hospital, Southeast Sulawesi Province. This type of qualitative research with a case study approach. The research was conducted at the Bahteramas RPSA Hospital, Southeast Sulawesi Province, Kendari City, with the reason that this hospital is a referral hospital for Covid-19 patient services. The informants in the study consisted of 2 regular informants and 5 key informants. Data was collected using observation, document review and in-depth interviews. Data analysis is done by matrix Content Analysis. The results showed that the process of storing PPE in the storage warehouse, during storage there are no obstacles found. The warehouse capacity is very sufficient for the storage and storage of PPE logistics supplies. The PPE storage is in accordance with the applicable SOP. There were no obstacles encountered when distributing PPE from logistics to health workers. Conclusion; The storage and distribution of PPE at the Bahteramas RPSA Hospital is considered quite good, because the storage of PPE in the pharmacy warehouse is in accordance with the applicable SOP. Meanwhile, the distribution of PPE to health workers is carried out through requests from each hospital service unit, according to the number of needs that will be used so that the needs of PPE in each service unit can be met properly.

Storage and distribution of personal protective equipment in national health insurance patient services during the Covid-19 pandemic at Bahteramas regional public service agency hospital Southeast Sulawesi Province, Indonesia

Storage and distribution of personal protective equipment in national health insurance patient services during the Covid-19 pandemic at Bahteramas regional public service agency hospital Southeast Sulawesi Province, Indonesia

Procurement of personal protective equipment in national health insurance patient services during the Covid-19 pandemic at Bahteramas Regional public service agency hospital Southeast Sulawesi Province, Indonesia

Procurement of personal protective equipment in national health insurance patient services during the Covid-19 pandemic at Bahteramas Regional public service agency hospital Southeast Sulawesi Province, Indonesia