Faculty of Public Health Journal Universitas Indonesia
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    AN ANALYSIS OF THE HEALTH CENTERS READINESS FOR ACCREDITATION IN BREBES DISTRICT IN 2018

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    Abstract. The accreditation of health centers is an endeavor by the Ministry of Health to improve the quality and performance of health centers regulated by Permenkes No. 4/2015. Of the 38 health centers in Brebes, only 10 has been accredited. We wish to discover how prepared are the health centers to be accredited based on the resources available and pre-accreditation survey. Data was obtained through in-depth interviews and documentary research. Results indicated that there was sufficient funds, facilities and equipment for the accreditation. However, the assessment scores for human resources sufficiency and documentary completeness was low. Abstrak. Akreditasi Puskesmas merupakan upaya peningkatan mutu dan kinerja pelayanan puskesmas yang diatur oleh Permenkes Nomor 46 Tahun 2015. Dari 38 puskesmas di Kabupaten Brebes, hanya 10 puskesmas yang sudah terakreditasi. Penelitian ini bertujuan untuk mengetahui seberapa siapkah Puskesmas di Kabupaten Brebes untuk menghadapi akreditasi berdasarkan variabel sumber daya dan tahapan kesiapan survei pra-akreditasi. Data dikumpulkan melalui wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan bahwa ketersediaan dana, sarana dan prasarana dinilai cukup siap untuk mendukung penilaian akreditasi puskesmas, namun hasil skoring assessment pada keterpemenuhan kompetensi SDM dan kelengkapan dokumen masih rendah.

    Audit Implementasi Clinical Pathway Diare Akut di Rumah Sakit Anak dan Bunda Harapan Kita Tahun 2016

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    ABSTRAK Penelitian ini bertujuan untuk mengetahui implementasi clinical pathway pada kasus diare akut dengan proses audit. Jenis penelitian ini adalah kuantitatif dan kualitatif dengan menggunaan konsep operational research dengan metode telaah dokumen, telaah data dan wawancara mendalam. Hasil penelitian didapatkan topik audit adalah implementasi clinical pathway diare akut dengan tujuan menilai kelengkapan pengisian clinical pathway, kepatuhan DPJP, PPJP, Gizi dan Farmasi serta menilai kesesuaian lama hari rawat dengan clinical pathway. Standar penilaian yang digunakan adalah standar nasional yaitu KARS. Hasil pengukuran menunjukkan bahwa kelengkapan pengisian clinical pathway 25%, tidak ditemukan variasi pada pemeriksaan laboratorium, asuhan nutrisi dan asuhan keperawatan, namun pada tata lakasana diare akut masih ditemukan variasi pada obat tambahan sebesar 41%, dan lama hari rawat sudah sesuai yaitu 3,3 hari. Beberapa hal yang perlu rumah sakit lakukan adalah mengembangkan kebijakan terkait clinical pathway, memperbaiki formulir clinical pathway dan sistem sosialisasi, membuat petunjuk teknis clinical pathway, sistem monitoring dan evaluasi, serta menurukan standar lama hari rawat dan diskusi terkait variasi terapi. ABSTRACT This study aims to determine the implementation of clinical pathway of acute diarrhea with the audit process. This type of research is quantitative and qualitative by using operational research concept with document review method, data analysis and in-depth interview. The result of the research shows that the audit topic is the implementation of clinical pathway of acute diarrhea with the aim to assessing completeness of clinical pathway, compliance of primary responsible physician, primary responsible nurse, nutrition and pharmacy and assessing the length of stay with clinical pathway. Assessment standard used is the national standard that is KARS. The result of measurement showed that completeness of filling clinical pathway 25%, no variation on laboratory examination, nutrition and nursing care, but still found variation on additional drug 41%, and length of stay was 3.3 day. Some things that hospital need to do is developed policies related to clinical pathway, improve clinical pathway forms and socialization systems, make clinical pathway technical guidance, monitoring and evaluation systems, and reduce standards length of stay and discussion of variations in therapy.

    Penggunaan Konsep Lean untuk Meningkatkan Efisiensi Pelayanan Instalasi Farmasi Rawat Jalan di Rumah Sakit Anna Medika Bekasi

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    ABSTRAK Jaminan Kesehatan Nasional yang dimulai tanggal 1 Januari 2014 merupakan bentuk transformasi sekaligus reformasi pelayanan kesehatan di Indonesia. Dalam pelaksanaannya, instalasi farmasi dituntut untuk meningkatkan mutu pelayanannya secara berkelanjutan sehingga pelayanan kefarmasian dapat menjadi efisien dan efektif dalam biaya. Lean merupakan sebuah sistem manajemen yang sepenuhnya berfokus pada efisiensi, dengan tujuan mengurangi biaya, siklus waktu layanan dan persediaan. Penelitian dilakukan pada bulan April–Mei 2016 di Instalasi Farmasi Rawat Jalan dengan titik fokus pada alur proses resep obat non puyer, menggunakan metode action research dengan melakukan pendekatan kualitatif dan kuantitatif. Hasil penelitian menggunakan konsep lean diketahui bahwa waktu proses untuk pengerjaan resep obat non puyer lebih besar dari waktu tempo yang ada. Hal ini menunjukkan instalasi farmasi rawat jalan belum mampu memenuhi kebutuhan pasien, adanya kekurangan jumlah sumber daya manusia pada shift siang, diperlukan tambahan sumber daya pendukung untuk membantu kelancaran pelayanan serta perlu dilakukan desain ulang pada alur proses pengerjaan resep obat non puyer. Desain baru tersebut dapat menghasilkan peningkatan persentase aktivitas value added sebanyak 22,73% yaitu dari 35,89% menjadi 58,62%. Untuk menjamin alur proses pelayanan baru dapat berjalan secara konsisten dan berkelanjutan, diusulkan ide perbaikan yang dibagi kedalam tiga tahap, yaitu jangka pendek, jangka menengah dan jangka panjang. ABSTRACT The National Health Insurance which was launched on January 1, 2014, is a form of transformation and reformation of health services in Indonesia. In implementation of the JKN, Hospital Pharmacy Installation is forced to improve its quality service sustainably in order to achieve cost effective and efficient service. Lean is a management system that fully focuses on effiency with the objectives to reduce stock, service cycle time and cost. Research was conducted on outpatient pharmacy installation service at Anna Medika Bekasi Hospital in April to May 2016. It focuses on prescription process flow of non-pulvis medicine using action research method with qualitative and quantitative approach. Lean concepts has been applied in this research. The result shows that the cycle time required for processing prescription of non-pulvis medicine is longer than the takt time. It indicates that outpatient pharmacy installation service is unable to fullfil the patient demand, there is lack of human resources on day shift, additional resources are required to support the service and process flow of non-pulvis medicine needs to be redesigned. This new design could result to increment 22.73% of value added activities from 35,89% to 58,62% To ensure the new process flow runs consistently and sustainably, some improvements, which are divided into short, medium and long term, are suggested.

    Utilization of Styrofoam as Soundproofing Material with Auditory Frequency Range

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    The utilization of bricks made of styrofoam is expectedly able to be a soundproof for noise control and as a preventive action to reduce the steadily increasing prevalence of hearing loss. This study aimed to assess the use of sound absorption material in which styrofoam was utilized to reduce the noise exposure. In this study, fine aggregates (sand and styrofoam) were made with a mixture of cement with a composition of 1:4 and 1:6, also the addition of polystyrene waste with a percentage of 0%, 20%, 40%, 60%, and 80%. Determination of acoustical property of the mixture was done by testing the sound absorption coefficient (α) using Four Microphones Impedance Tube (ISO 140-3). The results showed that the highest value of absorption coefficient was at a frequency of 800 Hz with an additional 80% styrofoam for the composition of 1:4 at 0.4100 dB and at a frequency of 800 Hz with an additional 40% styrofoam for the composition of 1:6 at 0.5870 dB

    Web-Based Application to Support Physical Fitness Information of Elderly People

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    The number of elderly people is more increasing along with the rising of the life expectancy age. There are many efforts that should be carried out to preventthe elderly, one of which from the preventive aspect is by maintaining the physical fitness of the elderly. To monitor the fitness status of the elderly, it needsan application of the web technology-based physical fitness monitoring because has been no system that records elderly fitness data. This application wasto record physical fitness data of the elderly to recommend the appropriate gym based on the health condition which can be accessed anywhere. This applicationwas made with the PHP and MYQSL program language as the database processing equipped by the graphic to monitor the physical fitness. The resultsof the test showed that the application worked properly. As indicated by the functioning of the designed and developed menues. The system was able torecord the individual data and the physical fitness of the elderly, also able to serve the information and the records of the fitness of the elderly people and theappropriate recommendation on fitness exercise.AbstrakPenduduk lanjut usia (lansia) semakin banyak seiring meningkatnya usia harapan hidup. Banyak upaya yang harus dilakukan untuk mencegah kesakitan dilansia, salah satunya dari aspek preventif dengan menjaga kebugaran para lansia. Untuk memonitor status kebugaran lansia, maka diperlukan aplikasi pemantauankebugaran jasmani berbasis teknologi web karena tidak ada sistem yang merekam data kebugaran para lansia. Aplikasi ini ditujukan untuk merekam data kebugaran jasmani para lansia untuk merekomendasikan gym yang sesuai berdasarkan kondisi kesehatan yang dapat diakses di mana saja. Aplikasi ini dibuat dengan bahasa pemrograman PHP dan MYSQL sebagai pengolahan basis data yang dilengkapi dengan grafik untuk memantau kebugaran jasmaninya. Hasil uji menunjukkan bahwa aplikasi mampu berfungsi dengan baik yang ditunjukkan dengan berfungsinya seluruh menu yang didesain dan dikembangkan. Sistem mampu merekam data individu serta kebugaran lansia. Sistem mampu menyajikan informasi dan riwayat kebugaran lansia serta rekomendasi latihan kebugaran yang sesuai

    Analysis of Factors Related to Employee Behavior in Implementing Patient Safety Program at Insan Permata Woman and Child Hospital Tangerang

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    Insan Permata Woman and Child Hospital was facing Patient Safety Incidence especially for periode of mid to late 2016 there were 12 incidents and 11 phlebitis cases. This indicated a gap between the conditions in the field and the ideal situation that should be achieved. This study aimed to see how the behavior of employees in implementing patient safety program and the factors that influence it. The sample of this study were 151 respondents as sample, consist of health and non health workers. The patient safety program focused on the accuracy of patient identification, reduction of risk of infection and reduction of risk of falling patients. This research was a quantitative research followed by qualitative method. The results showed that most employees already had good patient safety behavior, age and attitude were the most affecting factors in patient safety behavior. The lack of socialization of accreditation and patient safety, poor monitoring and some incomplete facilities should became the concern for the hospital as it was considered to have great influences in the daily implementation of patient safety program

    Analysis of Partnership of Private Practice Midwife in The National Health Insurance Program in District Bungo Jambi Province

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    On January 1, 2014, the government began to implement the National Health Insurance (NHI) program to realize social welfare for the whole community. Midwifery and neonatal care in the NHI program involves Puskesmas/family doctors and Private Practice Midwife (PPM) as its network. PPM participation in the NHI program in Bungo District was still lacking, only 12 (54.5%) PPM have cooperated with family doctors from 22 existing PPM. This study aimed to get an overview of PPM participation in the NHI program in Bungo District, Jambi Province. The study used qualitative research approach with Rapid Assessment Prosedur design, purposive sampling, and conducted in-depth interview to 10 PPM, Head of Health Office, MPKP BPJS Health Manager, and Chairman of Bungo Regency Section of Indonesian Midwife Organization (IMO). The study was conducted from January to July 2017. The study found that the knowledge, perceptions and attitude towards NHI program were good, but the perceived toward the claim and predetermined tariff procedures were not so good. PPM motivated to join the NHI program as many patients had become NHI participants. Support from the Government, NHI, and IMO were low, either in the form of socialization, or policies. Therefore, the study suggest an improvement in claims procedures, tariffs, and an increase of socialization from government, NHI and IMO on NHI program related to obstetric and neonatal care

    Management, Communication, Partnership, and Innovation Factors in Posbindu PTM Implementation Process in Gunung Batu Bogor City

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    By 2015 the deaths due to PTM are 68% and projected in 2030 to increase to 74%. Indonesia in 2013 based on Riskesdas data shows that 69.6% of diabetes mellitus and 63.2% of hypertension are still undiagnosed. The government's proactive efforts are through the implementation of Posbindu PTM which shows a very different number of visits in the target area of the Pasir Mulya Public Health Center. The purpose of this study is to know more in the description of management, communication, partnership and innovation in the implementation of Posbindu PTM and the factors that determine the results of the evaluation of the implementation of Posbindu PTM. This study is a qualitative study with in-depth interviews, focus group discussions (FGD), document review and observation at two Posbindu PTM with the highest and lowest visits to people with similar characteristics. The results of this study indicate that human resource management is a contributing factor in the implementation of Posbindu PTM,  communication and innovation need to be supported by partnership. The implementation of Posbindu PTM is supported by the optimization of management, communication, partnership and innovation factors that are interrelated in improving the successful implementation

    Equity Level of Health Insurance Ownership in Indonesia

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    Social health insurance from government program are expected to be able to reduce inequalities access to health services in the middle of rising of health care cost, while private health insurance is still limited for up and middle class population. This study aimed to analyze the equity level of health insurance ownership including social and private health insurance in Indonesia. This study examined the condition of Indonesia in the middle of entering National Health Insurance (NHI) era. This study used data of Indonesian Socio-Economic Survey 2012. Data were analyzed by using econometric approach through multinomial logit analysis. The results showed that the concentration index of social health insurance ownership was 0.615, which is smaller than private health insurance ownership (0.972). It means that Indonesia social health insurace ownership will be able to increase equity access to the health services especially for poor people (pro poor). Social health insurance ownership increases the use of the health services by people

    Psychosocial Determinants of Risky Sexual Behavior among Senior High School Students in Merauke District

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    Adolescents aged 10-24 years old are susceptible group to premarital sex, drugs abuse, and HIV/AIDS infection. Papua is the largest contributor to AIDS/HIV number in Indonesia. To overcome such problem, Rutgers WPF formed Dunia Remajaku Seru!(DAKU!), an intervention program towards adolescent reproductive health at senior high school level. This study aimed to determine psychosocial determinants of risky sexual behavior among senior high school students in Merauke District through cross-sectional approach. Samples were 1,364 second grade students that got DAKU!Program and matching process was conducted on schools that did not get DAKU!Program. Data analysis included univariate analysis, bivariate (chi square test) and multivariate (logistic regression test). Results showed that variables significantly related to adolescent risky sexual behavior were peer group with negative behavior, self-efficacy, parents’control, exposure to DAKU!Program and sex. Meanwhile, based on multivariate analysis, peer group with negative behavior (RP = 4.7 CI = 2.8 - 7.7) was the most dominant factor influencing risky sexual behavior.AbstrakRemaja usia 10-24 tahun merupakan kelompok yang rentan terhadap perilaku seksual pranikah, penyalahgunaan narkoba dan infeksi HIV/AIDS. Papua merupakan penyumbang angka HIV/AIDS terbesar di Indonesia. Untuk menanggulangi permasalahan tersebut Rutgers WPF membentuk suatu program intervensi kesehatan reproduksi remaja di tingkat sekolah menengah atas (SMA) yakni program Dunia Remajaku Seru! (DAKU!). Penelitian ini bertujuan untuk mengetahui determinan psikososial perilaku seksual berisiko pada siswa SMA di Kabupaten Merauke dengan menggunakan pendekatan potong lintang. Sampel berjumlah 1.364 siswa SMA kelas dua yang mendapatkan program DAKU!dan dilakukan proses pencocokan pada sekolah yang tidak mendapat program DAKU!. Analisis data meliputi analisis univariat, bivariat (uji kai kuadrat) dan multivariat (uji regresi logistik). Hasil analisis menunjukkan bahwa variabel yang signifikan berhubungan dengan perilaku seksual berisiko remaja adalah kelompok teman sebaya dengan perilaku negatif, efikasi diri, kontrol orangtua, keterpaparan dengan program DAKU!dan jenis kelamin. Sedangkan berdasarkan hasil analisis multivariat, kelompok teman sebaya dengan perilaku negatif merupakan faktor yang paling dominan memengaruhi perilaku seksual berisiko

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