Jurnal Keperawatan Padjadjaran
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Analyzing Factor that Affecting of Ventilator Associated Pneumonia
No full textAbstractBackground: Ventilator associated pneumonia (VAP) has been known to be the most common nosocomial infection in Intensive Care Unit (ICU). VAP increases length of care, cost, morbidity and mortality of patients in ICU. The ICU of RSMH Palembang have already been doing prevention of VAP incidence through VAP bundles, but the number of incidence were still high. Purpose: This study aimed to identify the factors associated with VAP incidence among the patients in ICU RSMH Palembang. Method: this study was quantitative study with kohort prospective approach. Samples were recruited from ICU RSMH Palembang using consecutive sampling technique for 4 months period (n=61). Data were collected using a questionnaire package consisting of a demographic questionnaire, CPIS instrument, APACHE II, an observation sheets that measure duration of using antibiotics, duration of using ventilator, reintubation and hand hygiene compliance. Data were analyzed using descriptive quantitative and logistic regression analysis. Results: VAP occured in 12 patients (19.7%). Bivariate test result with α:5% have shown that APACHE II (p:0.043), duration of using antibiotic (p:0.023), duration of using ventilator (p:0.001) and reintubation p:(0.001) were related to the incidence of VAP. Logistic regression analysis shows that reintubation (OR=0.035; CI 95%:0.28-0.658; p=0.013) and duration of ventilator > 5 days (OR=0.082; CI 95%: 0.09-0.74; p=0.026) were significant factor that affecting VAP. Conclusion. Reintubation was the most related factor with VAP incidence. It is recommended for doctors and nurses to conduct a proper and thorough assessment before extubation to minimalize the risk of reintubation
Development of Team Cohesiveness Measurement Instruments in Interprofessional Collaborative Practice in Health Care
No full textAbstractHealth care management has an obligation to always provide safe, sustainable, comprehensive, quality and satisfactory health care for both the service user and care provider. The management and culture are built through the Interprofessional Health Care Collaborative Practice Model (MPIPK), which are implemented through four model components, i.e. the clinical pathway of patient management, team management of patients, patient care integrated documentation, and interdisciplinary patient problem solving through interdisciplinary case conference forums. In order to realize interprofessional collaboration practices, a cohesive climate is required that supports group functions and performances, and an instrument is needed to measure the team cohesiveness of this model. This research was conducted to develop a team cohesiveness measurement instrument in the interprofessional collaboration of health care. The instrumentation research design was carried out through the following steps: 1) Preparations of the instrument design commenced from the synthesis theory related to collective culture and individual culture on four components of the model; 2) Validation of the contents of the instrument with related experts; 3) Construct validation with 237 healthcare practitioners in an accredited hospital setting. Expert judgment results on instrument relevance (CVI) ranged from 0.77 to 0.91, the essence of instrument contents (CVR) was in range (+) 0.27 - 0.63, CVI and CVR scores indicated the relevant and essential content of the instrument. Test results of all constructed items were valid (0.283 - 0.847) and reliable, α Cronbach on 4 components (0.792 - 0.963) so, it is feasible to be used to measure the team cohesiveness
Analisis Risiko Kesehatan dan Keselamatan Kerja (K3) pada Perawat
No full textPerawat merupakan petugas kesehatan dengan presentasi terbesar dan memegang peranan penting dalam pemberian pelayanan kesehatan. Dalam menjalankan tugasnya perawat berisiko mengalami gangguan kesehatan dan keselamatan kerja (K3). Penelitian ini bertujuan untuk menganalisis risiko K3 pada perawat di instalasi gawat darurat (IGD) Rumah Sakit Umum Daerah dr. H. Soemarmo Sosroatmodjo dalam rangka mencari upaya pengendalian risiko yang tepat sehingga perawat terhindar dari kecelakaan kerja dan penyakit akibat kerja. Penelitian mixed method telah dilakukan pada seluruh perawat di IGD yang berjumlah 20 orang (total sampling), penilaian risiko mengacu pada standar AS/NZS 4360:2004 tentang Risk Management. Untuk mengkaji likelihood, exposure, dan consequence digunakan pedoman wawancara dan job hazard analysis form. Penilaian tingkat risiko mengacu pada rumus dan tabel “William Fineâ€. Disimpulkan, bahaya level terbesar diperoleh pada tindakan memasang infus berupa risiko tertusuk jarum suntik, terpapar darah pasien, posisi tubuh yang salah, terpapar virus hepatitis, dan low back pain. Nilai Consequences (C), Exposure (E), dan Likelihood (L) pada tindakan ini adalah C:5, E:6, dan L:6. Rumah sakit disarankan untuk melakukan upaya pengendalian lebih lanjut sesuai dengan hirarki pengendalian K3.Kata kunci: Analisis risiko, instalasi gawat darurat, kesehatan dan keselamatan kerja, perawat. Health and Safety Risk Analysis of NursesAbstractNurses are health care workers with the largest presentation and plays an important role in the health services. In performing its duties, nurses are at risk for health and safety disturbances. This study aimed to analyse the risk of health and safety of nurses in the emergency room (ER) of dr. H. Soemarmo Sosroatmodjo Hospital, in order to find appropriate risk control so that nurses avoid to work accidents and occupational diseases. Mixed method research has been done on all nurses in ER which amounted to 20 nurses (total sampling). Risk assessment refers to the standard of AS/NZS 4360:2004 on Risk Management, interview guide and job hazard analysis form was used to assess the “likelihoodâ€, “exposureâ€, and “consequenceâ€. Assessment of risk level refers to the formulas and tables of “William Fineâ€. It is concluded that the greatest danger level obtained on the actions of an intra venous drip, consists of the risk of needlestick injuries, exposure to the patient’s blood, wrong body position, exposed to viral hepatitis, and low back pain. The values of consequences (C), exposure (E), and likelihood (L) in this action are C:5, E:6, and L:6. Hospitals are advised to make further control efforts in accordance with health and safety control hierarchy.Keywords: Emergency room, health and safety, nurses, risk analysis
Relationship of Family Support Towards Self-Management and Quality of Life of Patients with Type 2 Diabetes Mellitus
No full textDM disease will be suffered for life, so the patient is expected to establish self-management behavior in managing the disease. Self-management behavior in patient tends to decline with increasing complications perceived by patients. The presence of social support one of important factors to improve adherence of self-management Diabetes patients. The purpose of this study was to assess the relationship of social support towards self-management and the quality of life in DM patients in Bandung. This research used correlational approach with purposive technique sampling. Numbers of respondent were taken from the region of 10 Puskesmas with highest DM in Bandung on 92 patients who came to Puskesmas. The questionnaires used were Hensarling Diabetes Family Support Scale (HDFSS), Summary of Diabetes Self-management Activities Measure (SDSCA) and SF-36. The analysis used analysis using frequency distribution, and Spearman-rho. Most respondents (51.1%) had social support below the group median. Most respondents (50%) had a quality of life below the group median. Most respondents (52.2%) had DM self-management behavior below the group median. Bivariate results showed no relationship between social support support and self-management and quality of life of respondents (p value = 0.801). There is no significant relationship between social support and self-management and quality of life. Therefore, the studies are expected to be recommendations of this study was integrate nursing care to improve self-management and quality of life of DM patients
Pengalaman Perawat dalam Pelaksanaan Sistem Pemberian Pelayanan Keperawatan Profesional di RSUD Cibabat: Studi Fenomenologi
No full textPelayanan kesehatan bermutu merupakan salah satu wujud dari tuntutan masyarakat di era globalisasi saat ini. Implementasi Sistem Pemberian Pelayanan Keperawatan Profesional (SP2KP) sebagai salah satu upaya dalam peningkatan mutu pelayanan di Rumah Sakit. Penerapan SP2KP yang tidak sesuai standar akan berpengaruh terhadap kualitas pelayanan kesehatan. Penelitian yang mengkaji tentang pengalaman perawat dalam melaksanakan SP2KP masih terbatas. Penelitian ini bertujuan untuk mengeksplorasi pengalaman perawat dalam pelaksanaan SP2KP. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi. Pengumpulan data dilakukan dengan cara indepth interview. Partisipan adalah perawat yang terlibat dalam pelaksanaan SP2KP di ruang penyakit dalam yang berjumlah 7 partisipan. Pengambilan sampel dilakukan dengan cara purposive. Analisis dilakukan dengan metode Colaizzi. Dari hasil penelitian teridentifikasi 5 tema, yaitu: 1) Ketidaksamaan persepsi tentang SP2KP. 2) Hambatan melaksanakan SP2KP dengan baik. 3) Tanggung jawab dan tuntutan organisasi, 4) Hambatan menyeimbangkan tanggung jawab dan tuntutan organisasi. 5) Perlu peningkatan keterampilan profesional dan reward. Hasil penelitian menunjukan bahwa pelaksanaan SP2KP belum berjalan optimal karena beberapa kendala diantaranya: kurangnya komitmen dan dukungan dari berbagai pihak, perspektif antar perawat yang masih beragam dan unik. Untuk itu hendaknya pihak menejemen rumah sakit meningkatkan dukungan terhadap perawat SP2KP, melakukan penyelelarasan perspektif antar perawat, melakukan supervisi dan pengawasan dalam pelaksanaan SP2KP di ruangan, melengkapi fasilitas sesuai kebutuhan pasien dan merekrut perawat agar jumlah tenaga perawat sesuai dengan jumlah pasien, sehingga pelaksanaan SP2KP bisa berjalan optimal dan mutu pelayanan rumah sakit lebih meningkat.Kata kunci : Fenomenologi, perawat, SP2KP.  Nurse Experience in the Implementation of Professional Nursing Services System at Cibabat Hospital: Phenomenology Study AbstractQuality health services is one manifestation of the demands of society in this current era of globalization. Implementation of Professional Nursing Services System (SP2KP) as one of the efforts in improving the quality of service in the Hospital. Implementation of SP2KP that does not meet the standards will affect the quality of health services. Researches on the experience of nurses in implementing SP2KP are barely conducted. Therefore, this study aims to explore the experience of nurses in the implementation of SP2KP. This research uses qualitative method with phenomenology approach. Data collection is collected by in-depth interview. Participants were nurses who are involved in the implementation of SP2KP in the internal disease room which amounted to 7 participants. Sampling is collected by purposive method. The analysis was done by using Colaizzi method. As a result, there were identified 5 themes, namely: 1) Inequality of perceptions about SP2KP. 2) Obstacles to implement SP2KP well. 3) Responsibilities and demands of the organization, 4) Obstacles to balance organizational responsibilities and demands. 5) Need improvement of professional skill and reward. The results showed that the implementation of SP2KP has not run optimally because of several obstacles such as: lack of commitment and support from various parties, nurse perspectives are still diverse and unique. As a solution for the problem, the hospital management should increase the support to SP2KP nurses, to align the perspectives between nurses, to supervise and supervise SP2KP implementation in the room, to complete the facilities according to the needs of the patients and to recruit the nurses so that the number of nurses in accordance with the number of patients, so that the SP2KP implementation can run optimally and the quality of hospital services will increase. Keywords: Phenomenology, nurse, SP2KP.Â
Implementation of Roles and Functions of Case Managers
No full textCase management is an intervention strategy used by health care providers and systems to support clients, coordinate health services, and facilitate results in both price and quality. In this model of care, the case manager plays an important role in ensuring that the case management service flow is well implemented. This study aims to see how the role of case managers in carrying out their functions such as utility assessment, planning, facilitation and advocacy, service coordination, evaluation, and post-discharge follow-up. The research method used is the mixed method sequential exploratory design. This method explores the work experience of a case manager in the field, then composes a measuring instrument, and then seeks to quantify the role and function of the case manager. The population in this study was the case managers in the Kemuning and Fresia Building at Dr. Hasan Sadikin General Hospital Bandung amounting to 36 people. The research sample was divided into two, in the qualitative stage the number of participants as many as 5 people was determined by purposive sampling technique, and the quantitative stage used a total sampling of 36 people. The results showed that the qualitative analysis of the assessment function identified indicators of ability to collect data, analysis, and stratification of patients; in the planning function the ability to determine goals, take joint decisions and identify problems were identified; in the facilitation function and advocacy, the ability to be identified as an educator, protector of patient rights and solution provider were identified; in the service coordination function, the ability for team communication and communication between lines were identified; in the evaluation function the ability to evaluate patients and self-evaluation were identified; and in the post-discharge follow-up function the ability related to continuity of service was identified. In the implementation, the case manager carries out those functions, 4 functions are still carried out improperly by most respondents such as the joint decision making, team communication, patient evaluation, and self-evaluation
Comparison of Lecture and Video Methods in Increasing Caregiver Knowledge in Treating Clients Halusination
No full textEfforts to improve caregiver’s knowledge on hallucination is by providing an education the caregivers. Enhancing such knowledge can be carried out by different methods, include lecture and watching video methods. The purpose of the present research was to compare the effectiveness of lecture and watching video method in enhancing caregiver’s knowledge on hallucination.         The research used a quasi-experiment method with a pretest and posttest group design, with the research sample was 60. The sampling technique used was a total sampling. The scores of caregiver’s knowledge were determined by a questionnaire of knowledge on hallucination that was self-developed by validity test (0.707) and reliability test (0.968). The data obtained was then tested by using Independent Sample T-test, Mann-Whitney test, and Wilcoxon test.         The result of pretest of caregiver’s knowledge before the intervention showed that there was no difference between intervention and control group (p-value=0.624), while result of posttest of caregiver’s knowledge after the intervention showed that there was a significant difference between lecture group and video group (p-value=0.000). The research findings revealed that there was a significant increase in the scores of knowledge for both methods (p-value=0.000), but the increase of video group’s knowledge score was higher (4.23) than that of lecture group (2.57).         The conclusion of the research was that wathing video method was more effective than lecture method in enhancing caregiver’s knowledge so that video can be used as an alternative method for mental health education
Efforts in Hypercholesterolemia Treatment Using Turmeric (Curcuminoid) Extract Phytotherapy on Obese Patients: Preclinical Study
No full textHypercholesterolemia is an escalation in total cholesterol levels in the blood which can cause various cardiovascular diseases, hypertension, and stroke. Obesity is one of the risk factors of hypercholesterolemia. Turmeric extract (a curcuminoid) therapy including phytotherapy can be used to overcome hypercholesterolemia. This research aims to identify hypercholesterolemia with turmeric extract for obesity patients. The method used in this research was quasi-experimental with one group pretest and posttest design. The sampling technique used in this research was purposive sampling. The research subjects consisted of 18 respondents who met the criteria of hypercholesterolemia (total cholesterol> 200 mg/dl) or with obesity who had a body mass index (BMI)> 25 kg /m²) and they were not taking cholesterol-lowering drugs. Subjects were given turmeric extract with a dose of 1 gram/day for 28 days. Before and after the intervention, total cholesterol levels of respondents were examined. Data analysis was done by using t-paired test. The results showed that the average total cholesterol level before the patient was given turmeric extract therapy was 234.44 mg/dl and 202.06 mg/dl after the treatment. There was a significant decrease in the average cholesterol level after they were given turmeric extract therapy with p-value 0.0001 (ɑ <0.05). The results showed that there was a significant decrease in cholesterol levels, although it was still included in the category of borderline high cholesterol levels. Researchers suggest that respondents continue their turmeric extract therapy with a low cholesterol diet until their total cholesterol levels achieve the normal state
Foot Massage Modification to Reduce Blood Pressure in Pregnant Woman with Preeclampsia
No full textThe Maternal Mortality Ratio (MMR) in Indonesia remains high, including in West Java province. One of the MMR causes is preeclampsia (24%). Currently, the management of preeclampsia is focused on pharmacological therapy. Preeclampsia is characterized by high blood pressure. Some studies revealed that non-pharmacological therapy was effective in dealing high blood pressure including foot massage. Foot message has benefits both physiologically and psychologically. However limited study applied this massage among pregnant women with preeclamsia. The aim of this study was to determine the effectiveness of as a complementary therapy: foot massage to reduce of blood pressure among pregnant women with preeclampsia. The study applied quasi experimental design with time series approach. The samples were chosen using consecutive sampling technique. This study involved 30 pregnant women with preeclampsia. There were two steps of data collection. First, respondents’ blood pressure was measured by researchers without any interventions for 6 days. Second, the 7th -12th respondents had 20 minutes message, and observed blood pressure at the first minute before massage (pr-etest), and the 30th minutes after massage (post-test). Data were analyzed using Friedman Test.The result showed that there were no significant differences of mean systolic and diastolic blood pressure between pre-test and post-test (p> 0.05) in control period. Whereas, in the treatment period showed that there were a significant differences of mean systolic blood pressure between pre-test and post-test on the seventh day until twelfth day (p < 0.05). While, the significantly differences in mean of diastolic blood pressure between pre-test and post-test were present during the eighth until twelfth in treatment period (p < 0.05). This study revealed that there were significant differences in decreasing of blood pressure among pregnant women with preeclampsia after treatment by foot massage. The foot massage techniques can be used as one of the interventions to lower blood pressure in pregnant women with preeclampsia, however further research is needed to support the evidence based for nursing intervention especially in complementary therapies
Hubungan antara Fatigue, Jumlah CD4, dan Kadar Hemoglobin pada Pasien yang Terinfeksi Human Immunodeficiency Virus (HIV)
No full textKeberadaan Human Immunodeficiency Virus (HIV) di dalam tubuh secara terus menerus menyebabkan gangguan pada hampir semua sistem tubuh yang berdampak pada munculnya gejala kelelahan (fatigue). Fatigue banyak dilaporkan pada penderita HIV/AIDS dengan prevalensi berkisar antara 20% sampai 60%. Penelitian ini bertujuan menguji hubungan antara fatigue dengan jumlah CD4 dan kadar Hb pada pasien HIV/AIDS. Sebanyak 77 responden direkrut secara purposif di sebuah Klinik Rawat Jalan Rumah Sakit di Kota Bandung. Fatigue diukur menggunakan kuesioner HIV Related Fatigue Score (HRFS). Data yang terkumpul dianalisis menggunakan uji pearson correlation. Hasil penelitian menunjukkan terdapat hubungan yang bermakna antara fatigue dengan jumlah CD4 dalam darah (r = -.289, p< 0.05) dan kadar Hb (r = -.349, p< 0.05). Selain itu, kadar Hb memiliki hubungan yang bermakna dengan jumlah CD4 pada pasien HIV/AIDS (r = .360, p < .01). Hasil penelitian ini mengindikasikan perlunya monitoring kadar CD4 dan Hb secara berkala dan melakukan intervensi untuk mengatasi penurunan Hb dan CD4 sesegera mungkin sehingga dapat mencegah agar fatigue tidak berkelanjutan.Kata kunci: CD4, fatigue, hemoglobin, HIV/AIDS. The Correlation of Between Fatigue, CD4 Cell Count, and Hemoglobin Level among HIV/AIDS PatientsAbstractThe existence of Human Immunodeficiency Virus (HIV) in the body continuously causes disruption in almost all body systems that impact on the emergence of symptoms of fatigue. Fatigue was widely reported in HIV/AIDS patients with prevalence ranging from 20% to 60%. This study examined the relationship between fatigue and CD4 cell count and hemoglobin levels in HIV/AIDS patients. A total of 77 respondents were recruited purposively in Outpatient Clinic, General Hospital Bandung City. Fatigue was measured using the HIV Related Fatigue Score (HRFS) questionnaire. The collected data were analyzed using pearson correlation product moment. The results showed there were significant relationship between fatigue and CD4 count in blood (r = -.289, p< 0.05) and hemoglobin level (r = -.349, p< 0.05). In addition, CD4 had significantly correlation with Hb (r = .360, p < .01). The results of this study indicated that nurses or health care providers need to periodically monitor the CD4 and Hb levels and provide early intervention to manage the hemoglobin and CD4 cell count at optimum levels to prevent prolonging fatiguel.Keywords: CD4, fatigue, hemoglobin, HIV/AIDS