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"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 169-173Dentist is a specialist who must treat all types of disorder practically, involving the stomatognathic system. Unfortunately not all society has recognized the dentist's value within the "Total Healt Care System". ln developed socieus, the dentist is required to be involved in handling the emergencies, although not all members of the profession seem adequately prepared to deal with them without physician's help. In other hand, we know that most patient come the dental clinic as out patients, and therefore if emergency cases occurs in a dental clinic, it requires emergency treatment immediately. This might be caused by the lack of consciousness; it is only a temporary condition where the patient usually recovers quickly after first aid has been administered. However, the dentist might also be confronted with a more serious condition, which may present a great risk for the patient's life such as anaphylactic shock. In this condition, the dentist must know precisely which step to take if there is an emergency case. This paper discussed about emergency situation in dental practice and its management, so that the dentist can manage emergency cases in the dental practice in order to avoid any harmful action for the patient's life."

"Rumah sakit berperan krusial untuk memberikan pelayanan dalam situasi kedaruratan kesehatan masyarakat. Penelitian ini membahas kesiapan rumah sakit di Indonesia menghadapi kedaruratan kesehatan masyarakat dengan desain literature review. Tujuan dari penelitian ini adalah diperolehnya informasi mengenai gambaran kesiapan rumah sakit dalam menghadapi kedaruratan kesehatan masyarakat melalui komponen kesiapan hospital emergency response checklist dari WHO serta mengidentifikasi faktor - faktor yang menghambat kesiapan rumah sakit. Penelitian ini menggunakan basis data PubMed, ProQuest, Science Direct, Library UI, dan Google Scholar. Hasil pencarian menunjukkan dari 1667 studi teridentifikasi, 11 artikel memenuhi kriteria inklusi. Seluruh komponen kesiapan terdapat dalam studi. Kesimpulan penelitian adalah komponen komando dan kontrol merupakan komponen paling siap untuk menghadapi kedaruratan kesehatan masyarakat dan komponen pemulihan pasca bencana jarang dipertimbangkan. Faktor hambatan yang ditemukan diantaranya adalah ketidaksiapan perencanaan kedaruratan, tidak tersedianya anggaran, kurangnya pelatihan dan simulasi untuk komunikasi darurat dan penanganan bencana, belum tersedianya kebijakan dan SPO untuk berbagai komponen kesiapan, kurangnya perhatian pada jalur evakuasi, tidak tersedianya area penanggulangan bencana untuk kapasitas lonjakan, tugas pokok dan fungsi tim bencana yang tidak jelas, logistik yang tidak dipersiapkan, dan penanganan infeksi yang belum sesuai standar.

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Hospitals play a crucial role in providing services during public health emergencies. This study discusses the readiness of hospitals in Indonesia to face public health emergencies with a literature review design. The purpose of this study was to obtain information on the description of hospital readiness in dealing with public health emergencies through the components of the WHO's hospital emergency response checklist and identify factors that hinder hospital readiness. This research uses PubMed, ProQuest, Science Direct, Library UI, and Google Scholar databases. The search results showed that of the 1667 identified studies, 11 articles met the inclusion criteria. All components of readiness are included in the study. The conclusion of the study is that the command and control component is the most prepared component to deal with public health emergencies and the post-disaster recovery component is rarely considered. Various obstacles found including the unpreparedness of emergency planning, unavailability of budget, lack of training and simulations for emergency communication and disaster management, unavailability of policies and SOPs on various components, lack of attention to evacuation routes, unavailability of disaster management areas for surge capacity, unclear main tasks and functions of disaster teams, unprepared logistics, and handling of infections that are not up to standard. "

"Indonesia merupakan negara dengan keadaan geografi cenderung sering terjadi bencana alam. Demikian pula Jawa Barat yang mempunyai banyak gunung berapi yang masih aktif. Maka menjadi pertanyaan sudahkah Rumah Sakit Umum Daerah di wilayah Cirebon siap menghadapi bencana ?Penelitian ini bertujuan untuk mengetahui kesiapan Rumah Sakit Umum Daerah di Wilayah Cirebon dalam menghadapi bencana, dilakukan studi deskriptif dengan rancangan komparasi atas standar Baku terhadap keadaan 7 Rumah Sakit Umum daerah, melalui pendekatan kuantitatif data sekunder dan kualitatif.Informan dalam penelitian ini seluruh Direktur RUD dan seluruh Kepala Instalasi Instalasi Rawat Darurat se-Wilayah Cirebon. Digunakan analisa univariat dari data kuesioner kemudian dilakukan pembobotan sehingga dihasilkan skor kesiapan IRD, selanjutnya dilakukan analisa kesenjangan melalui wawancara mendalam dengan memperhatikan apa, siapa, mengapa, dimana, kapan dan bagaimana ketidaksiapan IRD.Hasil penelitian menunjukkan bahwa seluruh Rumah Sakit Umum Daerah di Wilayah Cirebon tidak siap menghadapi kegawat daruratan bencana/sehari-hari. Setelah dilakukan analisa kesenjangan maka yang menjadi alasan ketidak siapan adalah;Pertama: kurangnya dukungan para Direktur Rumah Sakit Umum Daerah terhadap Sistem penanggulangan Gawat Darurat Terpadu Bencana/Sehari-hari (SPGDT-B/S) yang disebabkan antara lain adalah kurangnya pemahaman akan SPGDT-B/S, kurangnya sosialisasi tentang standar klasifikasi IRD di Indonesia, standar kendaraan pelayanan medik dan yang penting juga adalah keterbatasan RSUD ermasuk Pemerintah Kota dan Kabupaten.Kedua: kurangnya kepedulian Kepala IRD selaku manajer penanggulangan kegawat daruratan terpadu bencana dalam mengelola sumber daya akibat kurangnya dukungan manajemen. Ketiga: kurangnya sosialisasi SPGDT-BIS serta dukungan akan kelengkapan sumber daya IRD dari Departemen Kesehatan Khususnya Direktorat Jenderal Pelayanan Medik.

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Indonesia is a state that geographically tends to face with natural disasters. So the question is, are general hospitals ready to face disasters?

This research aimed at knowing the readiness of General Hospital at Cirebon Regions in facing with disasters. This research is a descriptive study using comparative design based on the standard to the conditions of 7 General Hospital through qualitative and quantitative data approaches.

The informers in this research are all Directors of General Hospitals and all Head of Emergency Units at Cirebon regions. A uni-variant analysis is used generated from questionnaire data then scoring it to make level of readiness of emergency unit. Then a gap analysis was done through in-depth interview with take into consideration what, who, why, where, and when, and how the un-readiness of emergency unit.

The result of research shows that all general hospitals in Cirebon regions are not ready to face with daily emergency/disaster. After it is analyzed, the reason for unreadiness is due to:

First: lack of support from all director-of hospital to the Integrated System of Daily Emergency/Disaster Management (SPGDT-BIS) that caused by lack understanding to SPGDT-BIS, lack of socialization of standard classification of Emergency Unit in Indonesia, standard of medical service vehicle, and the important thing is lack of budget of general hospital including District and City Government.

Second: lack of attention of l-lead of Emergency Unit as manager of integrated emergency management in managing resources due to lack of support from management. Third: lack of socialization of SPGDT-BIS and support to the completeness of resources of emergency unit from Department of Health particularly from Directorate of Medical Services."

"Masalah ketidaklengkapan pencatatan dan pelaporan keperawatan merupakan salah satu masalah di ruang IGD. Penelitian ini bertujuan memberikan gambaran pelaksanaan dokumentasi keperawatan di ruang IGD RS. Medistra Jakarta. Penelitian deskriptif sederhana ini menggunakan 30 sampel berupa dokumen asuhan keperawatan. Hasil penelitian pelaksanaan pendokumentasian intervensi keperawatan di IGD RS. Medistra Jakarta paling efektif (96.7%) dibanding hasil pendokumentasian pengkqiian (33.3%), diagnosa (46.7%), implmentasi (46.'?%), dan evaluasi (60%). Adapun hasil pendokumentasian pengkajian paling tidak efektif (96.7%) dibanding hasil pendokumentasian diagnosa (53.3%), intervensi (33%), implementasi (53.3%), dan evaluasi (40%). Peneliti merekomendasikan pelatihan dan penyegaran pendokumentasian keperawatan baik konseptual maupun keterampilan secara berkala dan berkesinambungan agar pendokumentasian keperawatan menjadi lebih baik."

"Penanganan kasus gawat janin dengan sistem code green bertujuan mempercepat response time evakuasi janin ke luar rahim. Sistem code green telah dilaksanakan sejak tahun 2007 di Instalasi Rawat Darurat RSUP Sanglah Denpasar. Namun demikian belum pernah dilakukan evaluasi untuk mengukur keberhasilan penerapan sistem tersebut. Penelitian ini bertujuan untuk mengevaluasi penerapan sistem code green dengan pendekatan kualitatif dan disain studi kasus. Pengumpulan data primer dan sekunder didapat melalui wawancara mendalam dan observasi partisipatif. Dasar teori yang digunakan dalam penelitian ini adalah Theory of Constraints yang memandang sistem sebagai kesatuan mata rantai. Evaluasi juga dilakukan dengan menganalisis enam variabel pada diagram Ishikawa (fishbone diagram) meliputi man, method, material, machine, management dan milieu. Penelitian ini menemukan pemanjangan response time dalam sistem code green pada tahap penegakan diagnosis sampai menghubungi announcer sebagai the weakest link dari penerapan sistem. Variabel yang menyebabkan the weakest link dari sistem ini adalah sumber daya manusia yakni ketiadaan dokter penanggungjawab pelayanan (DPJP) di tempat kerja Ketiadaan DPJP (tidak on site) dalam penerapan sistem code green, terutama pada tahap pelayanan pertama yaitu penegakan diagnosis sampai menghubungi announcer berakibat fatal mengingat adanya keharusan bagi dokter residen kebidanan melaporkan dan meminta ijin terlebih dahulu kepada DPJP. Penelitian ini menyarankan agar pihak manajemen RSUP Sanglah Denpasar mengupayakan keberadaan DPJP di tempat tugas (on site), melakukan kajian standard opersional prosedur, dan melaksanakan monitoring penerapan sistem code green secara berkesinambungan.

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Code green system in management of fetal distress cases have purposes to improve response time on unborn baby evacuation process. Code green system have been implemented since 2007 in Emergency Department of Denpasar Sanglah General Hospital. However, there was no any evaluation process which was performed to assess the successes of implementation of code green system. The aim of this study is to evaluate the implementation of code green system with qualitative approach and case study design. Primary and secondary data were collected by a numbers efforts (by a few methods) such as in-depth interview, and observation participative. The theory of constraints (TOC) which postulate system as a chain was used as a based theory in this study. This study analyzed six variables of Ishikawa's diagram (Fishbone diagram) such as man, method, material, machine, management, and milieu.

This study found delay response time in code green system at the step of process from diagnosis to contact the announcer as a weakest link on the implementation of code green system. The cause of this weakest link was human resources. Obstetrician who in charge was not present during implementation of the code green system especially in the first step which the services was started from diagnosis until announcer informed when obstetric and gynecology resident reported and request approval from obstetrician who in charge in that critical moment. This study give recommendation such as to present an obstetrician who in-charge in field of services, to conduct a regular standard operational procedure review, and to perform continuing monitors and evaluations of code green system was needed."