Jurnal Manajemen Pelayanan Kesehatan
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HEALTHCARE FAILURE MODE AND EFFECT ANALYSIS: PROSES PELAYANAN OPERASI DI RUMAH SAKIT
Full text linkBackground: Most of medical errors are preventable. Highnumber of adverse event and near miss cases in hospitalsindicate opportunity for improvement. Therefore, efforts toidentify potential risks, recognize event as early as possible,and set a barrier mechanism through implementation of HealthCare Failure Mode and Effect Analysis (HFMEA) are required.This research was aimed to identify the risk of patient safetyincident (failure mode), in surgery care processes, the causeof failure mode in every stage and the prevention strategyusing HFMEA in hospital setting.Methods: This study employed an observation study to applyHFMEA in surgical care processes. Data were collected throughdirect observation of surgical preparation and procedures inthe ward and operating theatre, 18 interviews as well asdocument analysis and focus group discussions.Result: We found 25 activities that were not performed orpartially performed leading to 26 potential failure modes andfour critical patient safety incidents. The main cause of thepotential risk is non-effective communication. This is causedby neglected or violation due to frequent care transitionsbetween departments and shifts, lack of supervision, lack ofnurse competence, and absence of full-time surgeonts. Thesefindings show lack of patient safety culture as the underlyingcause.Conclusion: Poor communication and care transition is themain causes of potential safety incident in surgery careprocess. This can be prevented by process redesign andhealth care teamwork improvement.Keywords: communication, health failure mode and effectanalysis, surgery car
NURSING ERRORS DI UNIT PERAWATAN INTENSIF
Full text linkBackground: The complexity of care processes, patient’scritical condition, high workload, and high level of psychologicalstress among the nurses in the Intensive Care Unit (ICU) couldlead to potential nursing errors (NE). This research aims toidenti fy nursing errors, categories of pat ient harm,nurses’profile, and the contributing factors perceived by thenurse in the ICU of Dr. Oen Surakarta Hospital.Methods: This was an observational study conducted usingobservation method with TERCAP modification instrument toidentify any nursing practices in ICU to patients that wereadmitted during one-month study period. In total, 115 patientswere observed and the analysis was conducted descriptively.Results: We found 8 types of 15 NE events, i.e. self extubation(26,66%), uprooted of IV line (20%) and NGT (13,33%), wrongdose (13,33%), omission (6,67%), wrong reason (6,67%), reprickingin blood sugar examination (6,67%), and phlebitis dueto wrong route (6,67%). Eight events (53,33%) did not harmthe patients and the other 7 events (46,67%) harmed thepatients temporarily. The profile of nurses involved was mostlywith diploma education (93,33%), having special education/training (80%), and more than 3 years working period in theICU (86,67%). Eight TERCAP categories were related tomedication errors (33,33%), documentation errors (26,67%),lack of attentiveness (73,33%), inappropriate clinical judgment(73,33%), lack of prevention (26,67%), lack of/inappropriateintervention (13,33%), missed/mistaken interpretation(33,33%), and lack of professional responsibility (40%). Whilethe highest perceived contributing factor was overloaded task(73,33%).Conclusion: The common type of events was self-extubation.No permanent harm was found. This study recommendscontinuous dissemination on patient safety for nurses toencourage reporting of NE events.Keywords: intensive care, nursing errors, nursing practice
KUALITAS LAYANAN TUBERKULOSIS MENURUT SUDUT PANDANG PASIEN DI RUMAH SAKIT PEMERINTAH DAN SWASTA DI JAKARTA UTARA
Full text linkBackground: Patient’s perspective on the quality Tuberculosis(TB) care has received more attentions nowadays. While DOTSstrategy has been expanded in Indonesian public and privatehospitals since 2000, the quality evaluation from the patients’perspective is lacking.Objectives: To measure the quality of TB service from thepatient perspective in public and private hospitals in NorthJakarta.Method: This was a cross-sectional study design in twohospitals. The sample of patients in public and private hospitalswere 156 and 68 respectively. Data were collected usingQuality of Care as seen through the Eyes of the Patient (QUOTETB)instrument and analyzed desciptively.Result:In both hospitals, seven aspects should be improved(i.e. waiting time, safe drinking water, cost for services,transport support, food aid,TB-HIV and HIV prevention) .Patients in the public hospital perceived discrimination ofservices. Moreover six aspects of service should be improvedin private hospital (i.e. consistency of service, opening hours,TB service availability, additional charges, TB-HIV as well asHIV testing and treatment).Conclusion: Quality improvements for TB service in hospitalare needed. Hospitals should provide better facilities andenvironment, conduct cost analysis, improve TB-HIV service,adhere to the TB service procedure and improve providerpatientrelationship.Keywords: tuberculosis, patient perspective, quali ty ofservice, QUOTE-T
ANALISIS KEBIJAKAN PENGELOLAAN OSELTAMIVIR DAN IMPLEMENTASINYA DI RUMAH SAKIT RUJUKAN KASUS FLU BURUNG
No full textTERSEDIA DALAM FIL
DAMPAK JAMPERSAL PADA RASIO TENAGA KESEHATAN TERHADAP PASIEN DAN KELUARAN KLINIS PASIEN BERSALIN
Full text linkBackground: Jampersal is an insurance scheme policy forfree maternal delivery from Ministry of Health Republic ofIndonesia since 2011. Its general purpose is to decreasematernal and infant mortality through access to obstetricservices in many healthcare facilities. This program is expectedto increase patient visits and affect the health worker-to-patientratio and obstetric outcome as a result.Objective: To measure the effect of Jampersal implementationon health worker-to-patient ratio and obstetric outcome inObstetric Emergeny Room Department (OERD) of CiptoMangunkusumo Hospital Jakarta.Method: This study applied a pre-post test quasi-experimentaldesign. Subjects were chosen randomly from all deliveries.Number of all health workers, total member of patients in OERDin this tertiary care hospital were collected nine months beforeand af ter Jampersal implementation. Health worker perprofessional group per work shift were measured manuallyand divided by the number of patients per shift to obtain healthworker-to-patient ratio. Complication as an obstetric outcomewas measured from the medical record.Result: On average, health worker-to-total patient ratiodecreases f rom 5,53±2,36 to 3,73±1,04. Health worker-to-OERD inpatient ratio decreases from 7,97±6,61 to 1,34±0,49after Jampersal. While complication rate increases from 39,5%to 52,9% but not statistically significant.Conclusion: Jampersal affects health worker-to-patient ratiosignificantly which decreases the rate.Keywords: Jampersal, free maternal delivery policy, healthworker-to-patient ratio, obstetric outcome, complication
KEBIJAKAN SUBSIDI KESEHATAN BAGI KELUARGA MISKIN DAN KONSUMSI ROKOK DI INDONESIA TAHUN 2001 DAN 2004
Full text linkKorespondens
RISET OPERASIONAL PENINGKATAN KINERJA TIM KESELAMATAN PASIEN BERDASARKAN STANDAR INTERNASIONAL ENAM TUJUAN KESELAMATAN PASIEN
Full text linkBackground: Patient safety emphasizes reporting, analysis,and prevention of medical error that often leads to adversehealthcare events. In 2010, there were 60 incidents related topatient safety in Nyai Ageng Pinatih Hospital, Gresik, and thiscondition was incompatible with the hospital mission to providehealth care professionally and safely. The objective was toimprove the performance of patient safety team at motherchildhospital, Nyai Ageng Pinatih Gresik based on the SixGoals International Patient Safety (SGIPS) standards.Method: This research was an operational research.Respondents were 41 patient safety team members at theHospital. The intervention was carried out from May 7 untilJune 30, 2011, with pre and postintervention observations.Results: Conditions for the implementation of patient safetybased on SGIPS standards increased from 2.5 to 4.34 and thecriterion value is still on “not met”. Most individuals showedhigher awareness, after the intervention; Achieved increasedvalue of knowledge and participation and decreased personalobjective team members after the intervention. All individualparameters on team leader (coaching, monitoring, eliminateproblems performance, and set and update objectives)increased after the intervention.Conclusion: The study showed changes in awareness, personalobjectives, participation, and knowledge of patient safetyteam member after intervention. Coaching, monitoring, eliminateperformance problems, and set objectives and patientsafety team leader contributes to patient safety team performance.Keywords: patient safety, Six Goal International Patient Safety,tea
DAMPAK JAMPERSAL PADA RASIO TENAGA KESEHATAN TERHADAP PASIEN DAN KELUARAN KLINIS PASIEN BERSALIN DI RSUPN DR CIPTO MANGUNKUSUMO JAKARTA
No full textBackground: Jampersal is an insurance scheme policy for free maternal delivery from Ministry of Health Republic of Indonesia since 2011. Its general purpose is to decrease maternal and infant mortality through access to obstetric services in many healthcare facilities. This program is expected to increase patient visits and affect the health worker-to-patient ratio and obstetric outcome as a result.Objective: To measure the effect of Jampersal implementation on health worker-to-patient ratio and obstetric outcome in Obstetric Emergeny Room Department (OERD) of Cipto Mangunkusumo Hospital Jakarta.Method: This study applied a pre-post test quasi-experimental design. Subjects were chosen randomly from all deliveries. Number of all health workers, total member of patients in OERD in this tertiary care hospital were collected nine months before and nine months after Jampersal implementation. Health worker per professional group per work shift were measured manually and divided by the number of patients per shift to obtain health worker-to-patient ratio. Complication as an obstetric outcome was measured from the medical record.Result: On average, health worker-to-total patient ratio decreases from 5,53±2,36 to 3,73±1,04. Health worker-to-OERD inpatient ratio decreases from 7,97±6,61 to 1,34±0,49 after Jampersal. While complication rate increases from 39,5% to 52,9% but not statistically significant. Conclusion: Jampersal affects health worker-to-patient ratio significantly which decreases the rate.Keyword: Jampersal, free maternal delivery policy, health worker-to-patient ratio, obstetric outcome, complication
PENERIMAAN DOKTER DAN WAKTU TUNGGU PADA PERESEPAN ELEKTRONIK DIBANDINGKAN PERESEPAN MANUAL
Full text linkBackground: Since February 2009 hospital has been usingelectronic prescribing at outpatient clinics to reduce the medicinecollection waiting time at outpatient pharmacy.Objective: To describe the role of electronic prescribing inminimizing the risk during prescribing and transcribing, identifydoctors’ acceptance and also to compare patients, medicinecollection waiting time with electronic prescribing to manualprescribing.Methods: A study on doctors’ acceptance was a descriptivestudy by using quantitative analysis. Interview with doctorsregarding their experience in using electronic prescribing andalso interview with pharmacies getting information about therole of electronic prescribing in minimizing the risk during prescribingand transcribing was a quantitative analysis study. Astudy on comparing patients’ medicine collection waiting timewith electronic prescribing to manual prescribing was usingquasi-experimental method.Results and conclusions: Path analysis results showedthat perceived usefullness had bigger influence than perceivedease of use in term of acceptance of electronic prescribing.Most of doctors told that they have benefit of using electronicprescribing. Electronic prescribing could minimize the risk duringprescribing and transcribing and also reduce the waitingtime.Keywords: electronic prescribing, doctors’ acceptance, prescribing,transcribing, medicine collection waiting tim