Jurnal Keperawatan Padjadjaran
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Comparison of Four-Level Modification Triage with Five Level Emergency Severity Index (ESI) Triage Based on Level of Accuracy and Time Triase
No full textThe triage system currently recommended by the Association of Emergency Physicians (ACEP) and Emergency Nurses Association (ENA) is a five levels triage, Emergency Severity Index (ESI) due to more structured, concise, and clear. Cibabat Hospital used a relatively new triage of four modified levels of the Australian Triage Scale (ATS) which accuracy and time triage have not been evaluated. The purpose of this study was to compare the four level triage of modification of ATS and five levels of ESI triage based on accuracy and time triage. The researcher used a quantitative quasi-experimental design with samples of triage activities totaling 38 in the control group and 38 intervention groups, using accidental sampling techniques. Univariate analysis consisted of frequency distribution for nurse characteristics, time triage and accuracy, bivariate analysis used the Mann-Whitney test. The results showed there were no differences, triage modification of ATS with ESI triage in accuracy (p-0.488), and length of triage (p-0.488) ESI triage accuracy was in the expected triage category (76.3%), under triage (13.2%), and over triage (10.5%). Triage modified ATS, expected triage (73.7%), under triage (18.4%), and over triage (7.9%). ESI triage has more expected and less under triage than ATS modification triage. Under triage caused prolong waiting times, unexpected risks, increases morbidity and mortality. Based on the length of time, ESI triage averaged 167 seconds, triage modification of ATS an average of 183 seconds. ESI flowchrat is easier to understand because is simple, has slight indicators in each category. Conclusion of this study is there is no significant difference in the level of accuracy and duration of triage. However, based on data distribution, ESI triage gives more expected triage decisions, less under triage and 16 seconds faster. Suggestions given to the Cibabat Hospital, can use ESI triage as an alternative triage assessment option because easy to use, structured, simple, and clear
Factors Related to the Low Nutritional Status among Tuberculosis Patients
No full textTuberculosis and malnutrition are serious problems. Tuberculosis causes malnutrition that potentially lessen patients’ immunity and increase the risk for activating tuberculosis. The purpose of this study was to identify the factors related to the low nutritional status among tuberculosis patients in Malang City. This research applied a corelational study. The subjects involved were tuberculosis patients with BMI<18.5. Chi-square and Fisher Exact Test were used to analyse the identified factors. Moreover, binary logistic regression to identify factors related to the low nutritional status among tuberculosis patients in Malang City. This study found almost half of participants (46.8%) had poor family knowledge about dietary TB patients. More than half of the participant’s culture (62.5%) was abstinence. A more than half of participant (59.6%) had Moderate malnutritions. There was no significant correlation between low nutritional satus and variable of gender p=1.000, education p=0.404, family knowledge p=0.767, and culture p=0.310. The significant correlation was occupational status with p=0.043. The binary logistic regression showed that tuberculosis patient with unoccupied are 1.286 times more likely to have a low nutritional status. Occupational status was the one factor that significantly related to the low nutritional status among TB patients in Malang City
The Relationship between Dialysis Adequacy and Fatigue in Patients on Maintenance Hemodialysis
No full textFatigue and inadequacy dialysis are common problem in hemodialysis patients. The dialysis inadequacy can cause an increased progression of impaired renal function, as well as the increased morbidity and mortality, and declining productivity of hemodialysis patients. Fatigue prevalence ranged from 44,7-97% from mild to severe. Fatigue is a common complaint of hemodialysis patients that can lower physical function and life quality. To determine the correlation between adequacy and the fatigue level of the patients with End Stage Renal Disease (ESRD) undergoing hemodialysis. This study used a descriptive analytic and cross sectional approach involving 75 respondents and the FACIT-G Questionnaire was used to collect the data. The inclusion criteria are male and female patients aged 18-70, undergoing hemodialysis for more than 3 months with a frequency of 2 times at least 4 hours, composmentis patients. The adequacy hemodialysis was assessed using the Kt/V formula. All data were collected during the session of hemodialysis. Pearson Product moment test wes used to analyze the data. The mean dialysis adequacy was 1.43±0.380, 57(76%) only 13 (17.3%) patients had adequate dialysis (minimum laboratory standard Kt / v = 1.8) and inadequate were 62 (82.7%) patients. The mean of fatigue was 20.07 and 62 (82.7%) respondents experienced severe fatigue. There was no significant correlation between adequacy and the fatigue level of the patients with ESRD undergoing hemodialysis with p value 0.504 (α> 0.05). Mostly patients had inadequate dialysis, both adequate and inadequate dialysis patients had experience fatigue from mild to severe. Multiple individuale and personnel factors affect dialysis adequacy directly or conversely
Child Health Problems in Agricultural Setting
No full textBesuki Residency well known at agricultural field. Child and infant mortality in this area is high. Child health problems of agricultural-oriented at Besuki Residency no one has research yet. This research uses quantitative methods that are retrospectives that include child health problems since 2017 until 2018. Quantitative method is used to collect data on patient characteristics (gender, disease, nursing problems, and age criteria) and illness to the children’s disease based on agricultural that arise due to activities or agricultural climate. The sample included 807 children at seven hospital scattered in several residency areas using quota sampling technic. Data analysis uses confirmatory factor analyze (CFA), with parameter data estimation uses analysis of moment structures. The result of p-values for health problems to gender = 0.033 (p<0.05), health problems to disease = 0.008 (p<0.05), health problems to nursing problems = 0.000 (p<0.05), health problems to age criteria = 0.000 (p<0.05). Fit model value indicates that the model is perfect fit. Child health problems, especially such as pneumonia, diarrhea, and malaria in the agricultural area with an agricultural perspective in the Besuki Residency can affect gender, disease, nursing problems, and age criteria. So that these health problems require specific health interventions or programs according to the characteristics of gender, disease, nursing problems, and age criteria. The nurse should have a mapping of nursing problems and special agriculture-oriented interventions
Nurses’ Reflections on Challenges and Barriers of Communication in The Intensive Care Unit: A Phenomenology Study
No full textCommunication among nurses, patients, and families takes an important role in the intensive care unit in which the patients are in critical condition and unable to involve in two-way communication. Research related to effective nurse-patient communication has been done extensively, but the information regarding communication in intensive care unit is still limited. This research aimed to explore nurses’ experiences in the intensive care units in effective communication to patients/patient’s families. This was a qualitative study project with phenomenology approach. The data were collected using the in-depth interview technique approximately 60 minutes involving ten nurses who were selected using the purposive sampling at Al Islam Hospital Bandung. Data were analysed using the Colaizzi method and the results were presented in themes. Based on the nurses’ experiences, four themes were emerged in this study including (1) Nurses’ dilemma of their professionalism and personal issues/matters, (2) Contextual factor affects selection of nurses’ communication technique, (3) Barriers in effective communication; difficulties in accompanying families to accept critical patient conditions, care and treatment procedures in the ICU which were complicated, and misunderstanding between nurse-patient and family (4) Compassion and patience are required in nurse-patient communication in ICU. The complex patient/family conditions in the ICU require nurses to choose the appropriate communication technique accompanied by a sense of compassion and patience. Nurses need to improve their ability to communicate effectively in order to lower the barriers in communicating between nurses-patients/families. Recommendations, training and assistance of effective communication become important for nurses in improving services in the Intensive Care Unit
Demonstration and Audio-Visual Methods for Improving Knowledge, Attitude and Skills of Breast Care among Pregnant Women
No full textOne of the physical changes during pregnancy is their breasts that usually get larger and heavier, the areola mammae becomes darker and the nipples get bigger. These conditions cause the breasts need to be treated in preparation for exclusive breastfeeding. However, in reality, there are many pregnant women who have not done much breast care due to their ignorance of its importance and lack of information. The aimed this study was to identify the effective of audio-visual and demonstration method for improving knowledge, attitude, and skills of breast care among pregnant women in Aceh. This study was used a pre-test post-test design with a control group (37 of pregnant women) and intervention group (36 of pregnant women). The intervention group was given health education about breast care using demonstration method, while the control group was given by watching videos. The instruments used in this study was a questionnaire about breast care and checklist to assess breast care skill. The instruments was developed based on the existing theory. Data was analyzed using t-independent test (p<0.05). There were significantly difference of knowledge (72.83 + 8.48 vs. 45.43 +12.06), attitudes (58.76 +6.20 vs. 46.83 + 4.58), and skill (73.74 + 7.98 vs. 56.17+ 10.62) of breast care between intervention and control group among pregnants women (P<0.001). Furthermore, the scores of knowledge, attitudes, and skills of breast care among pregnant women using demonstration (intervention groups) method were more higher compared pregnant women using audio-visual method (control groups). Health education using demonstration method is more effective for improving knowledge, attitudes, and skills of breast care among pregnant women than audio visual method. Therefore, demonstrations and re-demonstration using guideline should be implement for women with guidance during pregnant
Factors Affecting Low Back Pain among ICU Nurses
No full textLow back pain is a pain syndrome that is often felt in the lower back region accompanied by spreading to the legs. It is often associated with work-related musculoskeletal disorders. This condition is often experienced by the Intensive Care Unit (ICU) nurses, from mild to severe LBP, which may affect the productivity of work and physic of the nurses. Aim to analyze and explore the factors that affected the number of low back pain incidents in ICU nurses in hospitals in the Banten Province. This study used the correlational analytic method with a crosssectional approach. The study sample was 82 ICU nurses, obtained by total sampling. Data collection used the LKQ questionnaire (Low back pain Knowledge Questions) and observation sheets. Data analysis used the Chisquare and multiple logistic regression analysis with a prediction model.  Knowledge factor p (0.001), height p (0.021), night shift frequency p (0.003), and weight with a p-value (0.021) had a significant relationship with low back pain, whereas the ICU space environment factor p (0.668), work period p (0.462), and age p (0.079) did not have a significant relationship with low back pain. From related factors, knowledge had the most significant relationship with low back pain incident (OR = 38.62). This study has significantly proven that knowledge, height, weight, and frequency of night shifts affected the low back pain in ICU nurses. The nurse’s knowledge factor is the most influential factor of low back pain incident in ICU nurses. Increasing the ICU nurse’s knowledge about body biomechanics by following training and developing standard operating procedures. It is suggested to reduce the amount of excessive night shift burden ICU nurses, select and setting criteria for nurses working in the ICU
Comparison of Central Venous Pressure (Cvp) Score among Patients on Mechanical Ventilator with Head of Bed (Hob) Elevation 30O; Neutral, Right, and Left Side Positions
No full textEarly mobilization is important for critical patients to improve cough reflexes, eliminate bronchial secretions, facilitate work of mucociliary drainage muscles, and to prevent associated pneumonia ventilators and pressure sores. However, at the same time the patient often experiences vital signs change due to fluctuating conditions. Central Venous Pressure (CVP) measurement is oftenly needed to monitor central circulatory system. Unfortunately, in the clinical setting, the patient’s position must be changed first in a 30o neutral head of bed (HoB) position rather than left or right side HoB position. This study aims to examine the differences in of CVP score among patients on mechanical ventilation at HoB position elevation 30o in a neutral, right side, and left side position. This quantitative comparative study involved 24 subjects who were recruited consecutively. Data were analyzed using ANOVA. The results showed that the mean CVP value at neutral HoB position elevation was 13.5 ± 3.96, right sight HoB elevation was 12.8 ± 4.16, and left side HoB elevation was 14.4 ± 4.17. There was a significant difference (p <0.05) among those three positions. Post hoc analysis test found the HoB position 30o neutral vs left side possition was higher and signifficantly difference with HoB elevation 30o neutral vs right side positions (p<0.05). This study suggested nurses need to consider the change of CVP values while changing patiens’ position of HoB elevation 30o neutral, right side, and left side positions. Athough there was statistically difference among three positions, in fact, the value difference was less than 1 cmH2O which clinically did not see any differences
Relationship between Workload Performance and Job Satisfaction
No full textIn Pakistan’s public health care delivery system, charge nurses hold a very challenging position to perform their workload. They have to work very hard to accomplish nursing and non-nursing care tasks which are imposed on them by the system. Overstretching of workload deprives them from concentration which is badly needed for their performance and this creates dissatisfaction which negatively impact on the quality of nursing care. As a result, this study intends to analyses the relationship between workload performance (WLP) and job satisfaction (JS). This correlation study involved 105 charge nurses in Nishtar Medical College and Hospital Multan Pakistan recruited by convenience sampling. Nurses’ WLP were collected by using self-developed instrument, and JS were collected by using modified Spector 1985. The collected data were analyze descriptively (mean, SD, frequencies, percentage) and inferentially (Pearson’s correlation). The results suggested that nurses’ WLP (average time consumption) in the morning (93.83%) and evening shift (95.63%) were higher compared with night shift (70.69%). Additionally, the proportion of time consumed in the morning and evening shift were higher on nursing care activities (Morning = 57.10%, Evening =52.1%) rather than non-nursing care activities. Oppositely, in the night shifts nurses consumed more than half of their time in non-nursing care activities (55. 66%). Charge nurses observed on moderate level of job satisfaction (mean = 38.6, SD = 5.42). There was no statistically significant correlation between nurses’ job satisfaction and workload performance (p =.137). The findings conclude nurses’ high workload and moderate level of job satisfaction and no statistically significant correlation between both. The results suggested that, it is important for hospital management to adopt some better strategies in order to improve WLP and JS
Relationship of Adolescents’ Characteristics, Smartphone Uses and Premarital Sexual Behavior in High School Students
No full textAdolescents’ problematic behavior is in relation to premarital sexual behavior. Adolescents’ premarital sexual behavior can cause abortion, unwanted pregnancy, death, potential HIV/AIDS infection as well as moral decency crime in Gowa District. Factors of premarital sexual behavior among adolescents include gender, origin of school, status and frequency of dating, religious norms, household norms, knowledge and the uses of smartphone. This research aims at analyzing adolescents’ characteristics of and the uses of smartphone in relation with premarital sexual behavior among high school students in Gowa District, South Sulawesi Province. It was the correlational design quantitative research. Total samples amounted to 500 high school students in Gowa District, South Sulawesi Province after these were selected with the cluster sampling. The questionnaire used in this research consisted of religious norms (the reliability test results of 0.791, R-value of 0.397-0.678), household norms (the reliability test results of 0.856, R-value of 0.430-0.893), knowledge (the reliability test results of 0.738, R-value of 0.362-0.514), and premarital sexual behavior (the reliability test results of 0.844, R-value of 0,483-0,763), smartphone use with the calculated R value > r table (0.514) the reliability indicates the alpha cronbach’s value> 0.60. The analyzed data use Chi square and logistic regression. The research results show that the premarital sexual behavior has total risk value of 66.0% and the unrisky value of 34.0%. It relates to some adolescents’ characteristics among others frequency of dating (p=0.000), status of dating (p=0.000), religious norms (p=0.000), household norms (p=0.000), knowledge (p=0.000), and smartphone use (p=0.000), the variables of adolescents’ characteristics i.e. gender and the origin of school do not have significant relationship (p> 0.05). The smartphone use is the most significant factor with the premarital sexual behavior (OR=3.583). The smartphone use is the most significant factor with premarital sexual behavior, and therefore, it indicates that teachers at school and parents at home should who carry out the control and adolescent education in the smartphone use are important factors to be upgraded. The school based health education program can avoid the risky premarital sexual behavior, and the program can focus on the control of smartphone use and skill training among adolescents