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"Instalasi rawat nginap B adalah suatu unit rawat nginap di RSUPN DR. Cipto Mangunkusumo dengan sistem pelayanan terpadu yang berkapasitas 339 tempat tidur. Pada saat ini di Irna B kurang tersedianya informasi mengenai formularium RSCM Edisi,-V di ruang rawat, sehingga banyak dokter menulis resep obat tidak sesuai dengan formularium yang harganya relatif mahal. Penelitian ini bertujuan untuk melihat apakah terdapat hubungan antara penulisan resep yang tidak sesuai dengan formularium rumah sakit dengan beberapa faktor yaitu pengetahuan dokter, kepemilikan buku formularium pengertian dokter dan sikap dokter terhadap buku formularium tersebut. Untuk mencapai tujuan tersebut, seluruh lembaran resep dikumpulkan dari tanggal 1 sampai 31 Agustus 1997. Dari lembaran resep tersebut dihitung jumlah resep dan dihitung pula berapa persen resep yang tidak sesuai dengan formularium. Kemudian dilakukan wawancara dengan dokter penulis resep untuk mengetahui beberapa faktor yang berhubungan dengan penulisan resep tersebut. Sebagai unit analisis selanjutnya adalah dokter, kemudian dilakukan analisis bivariat dan multivariat terhadap faktor-faktor tersebut. Hasil pengertian adalah sebagai berikut : Ditemukan 7034 resep yang ditulis oleh 121 dokter. Penulisan resep yang tidak sesuai dengan formularium RSCM edisi-V adalah 35. Ternyata faktor yang berhubungan secara bermakna dengan ketidak sesuaian penulisan resep dengan formularium adalah pengetahuan dokter tentang formularium RSCM edisi-V. Disamping itu diduga faktor pengertian dokter dan pemilikan buku formularium berperanan pula secara bermakna.

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Irna B (Instalasi Rawat Nginap B) is an integrated services ward in cipto mangunkusumo hospital with 339 bed capacity which provides variety of specialities and subspecialities health care. It has been assumed that hospital formulary currently available is not informed well to the medical staffs in the ward result in a high frequency of non formulary drugs prescribing.

The purpose of the study was to know if there was a relationship between non formulary prescribing and some factors, namely the awereness, the ownership of the book, understanding and the attitude of the prescribers to wards the hospital formulary.

All prescription sheets were collected from August. I until August 31, 1997. Total prescriptions and precentage of non formulary prescriptions and precentage of non formualry prescriptions were calculated, followed by interviewing the prescribers with regards to the factors associated with such prescribing. The prescribers were used as the analysis unit, then bivariate and multivariate analysis were performed to wards those factors.

The result showed that 2462 (35%) of 7034 prescriptions prescribed by 121 physicians, were non formulary drugs. The only factor that related to prescribing was the awareness of the physicians to wards the hospital formulary. Besides, the ownership of the formulary book and the prescriber's understanding to wards the hospital formulary were assumed to play a role."

"A research had been performed in order to get general description of the service of an oral complementary drug in the nursing ward of IRNA B of Perjan RS Dr. Cipto Mangunkusumo and it evaluated the operation of the oral complementary drug service was, and also found out the correlation of the orderly medication instruction writing of the oral complementary drug, the orderly operation of the process of the oralcomplementary drug procurement, drug preservation, drug preparation, the handover the oral complementary drug to a patient, and Communication, Information and Education (CIE) in the nursing ward of IRNA B relation to the orderly operation of oral complementary drug service procedure. The research used the cross sectional method of survey which was descriptive and analytic in its nature. Theresearch showed that 74,81% of the patients medication instruction writing in prescription did not fit the requirements in administration writing and medication information completely. 67,94% of the patients bought the prescription (76%-100%)form the drug store in RSCM, 42,75% of patients kept the 76%-100% of their drugin the pharmacy depot, 42,75% of patients prepared the 76%-100% of patient prepared the 76%-100% of their drug in unites of doses by the pharmacy depot. 64,12% of the patients were given their drug by nurses directly, and finished to swallow the drug according to its use direction, and there was none of the patients who got CIEservice from a pharmacist. The operation of the oral complementary drug service in the nursing ward of IRNA B was evaluated as less appropriate to the procedure. It could be concluded that there is significant correlation between medication instruction writing, the orderly operation of the process of the oral complementary drugpreservation, the drug preparation, the hand-over the oral complementary drug to a patient in the nursing ward of IRNA B with the orderly operation of oral complementary drug service procedure; and there is no correlation between the procurement ofthe oral complementary drug, the orderly operation of CIE in the nursing ward of IRNA B with the orderly operation of oral complementary drug service procedure."

"Era globalisasi menuntut penyedia pelayanan kesehatan meningkatkan mutu pelayanannya. Pelayanan paripurna merupakan hak setiap individu, keluarga, kelompok dan masyarakat. Upaya peningkatan kesehatan diarahkan agar memberi manfaat sebesar-besamya bagi peningkatan derajat kesehatan masyarakat, serta dilaksanakan dengan penuh tanggung jawab. Salah satu indikator pelayanan bermutu terpenuhinya pelaksanaan informed consent sesuai dengan hukum. Perjan RS CM merupakan RS rujukan nasional, pelaksanaan informed consent harus lebih balk dibandingkan dengan RS setingkat lainnya, namun sampai saat ini belum diketahui sejauh mana pelaksanaannya.Penelitian dilakukan di IRNA A (lantai I kid, III kanan-kiri, dan IV kanan) Perjan RSCM, Jakarta pada Juni - Agustus 2003. Desain penelitian, kualitatif deskriptif yang bersifat eksploratif dengan pendekatan sistem. Informannya : pasien (7), perawat (8), dokter (4), dan pengkajian dokumen informed consent (60). Pengumpulan data melalui wawancara mendalam, focus group discussion, observasi, kuesioner (pertanyaan terbuka - khusus dokter), dan pengkajian dokumen. Tujuannya untuk mengetahui pelaksanaan informed consent yang memenuhi aspek hukum.Penelitian menemukan bahwa (a). pengetahuan pasien/keluarganya mengenai hak dan kewajiban cukup bagus, walaupun saat masuk di RS tidak pemah diberi penjelasan, (b). pengetahuan perawat dan dokter mengenai peraturan per-uu-an yang mengatur informed consent masih rendah, (c). pemahaman pasien/ keluarganya mengenai informed consent dan dokumennya cukup bagus, (d). pemahaman perawat mengenai informed consent dan dokumennya cukup bagus, (e). peranan perawat dalam pelaksanaan informed consent sebagai saksi dan advokasi, (f). pemahaman dokter mengenai informed consent dan dokumennya cukup bagus, (g). informasi medis yang diberikan oleh dokter ke pasien/keluarganya pada umumnya mencakup : penyakit yang diderita pasien, rencana tindakan, dan efek samping, (h). pelaksanaan informed consent di Perjan RSCM belum sesuai dengan peratum per-uu-an yang berlaku (hukum), dan (i). enam puluh (60) dokumen yang dilakukan pengkajian tidak ada satu pun yang kolomnya terisi dengan lengkap, sehingga tidak ada yang memenuhi aspek hukum.Ada beberapa kelemahan dalam formulir informed consent, yaitu informasinya tidak tertulis sehingga mengakibatkan ketidak-jelasan informasi medis dan lemah sebagai alat bukti, pasien kurang memahami, untuk itu perlu dilakukan perbaikan, sehingga informasinya dapat diuraikan dalam formulir tersebut dan dijelaskan secara lisan. Hambatan pelaksanaan informed consent, tidak ada SOP, pemahaman pelaksana informed consent belum maksimal, rendah pengetahuan pelaksana tentang hukum informed consent, dan informasi disampaikan secara lisan.Implikasi dari temuan ini pentingnya pembuatan SOP informed consent dan pelaksanaannya selalu dievaluasi secara berkala untuk mengetahui keberhasilan dan kelemahannya, sehingga pelaksanaan informed consent yang memenuhi aspek hukum dapat diwujudkan.Daftar pustaka : 66 (1982 -2003)

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The Implementation of Informed Consent a Legal Aspect Point of View in IRNA A Perjan RS dr. Cipto Mangunkusumo, 2003In the globalization era, the expectation of health care service from the caregiver is high. The comprehensive care is a right for every human being, family and for the community. The effort in improving health care service is aimed of the highest advantage for community welfare on enhancing people health status. One of the indicators of the good health care is the accomplishment of informed consent on every patient. The national top referral Cipto Mangunkusumo hospital, suppose has already implemented the informed consent comparing to the other hospital in Indonesia, but still, it has not been discover what has been implemented.This study is going to explore the implementation of informed consent on certain installation IRNA A (l' floor, 3`11 floor, & 4t' floor) during June - August 2003. The methodology of this study is descriptive explorative using qualitative approach. The data resource are 7 patients, 8 nurses, 4 doctors and 60 informed consent documentation. Data collection using in depth interview, focus group discussion, observation, questioner and assessing the document. The aim of this study is to look at the implementation of informed consent as legal aspect.This study found that (a) the patient & family knowledge about informed consent are fairly good, although they do not get the information when they admitted to the hospital, (b) the knowledge of the nurses & the doctors on informed consent as an legal aspect are fairly poor, (c) patient & family perception on informed consent are fairly good, (d) nurses perception on informed consent are fairly good, (e) Nurse role on informed consent is as witness & advocate (t) doctors perception on informed consent are fairly good, (g) the information that usually inform to the patient are the medical diagnosis, the medical therapy and the side effect of the treatment (h) The informed consent on the Cipto Hospital are not well implemented and (i) sixty document of informed consent that had assessed are not well completed.There are some weaknesses on the informed consent form in this hospital, which are most of the information are not clearly written, that cause uncertain information and it is not powerful as a legal aspect, the patients are not well informed and need improvement. The constrain of implementing the informed consent are there is no standard, the perception of the caregiver are not sufficient and most of the information are verbally informed.The implication of this research suggest that hospital need to have standard to implement informed consent, it should be evaluated periodically that could improve the implement of informed consent,References ; 66 (1982-2003)"

"Surgical site infections are the second most frequent nosocomial infection after catheter infection. They are associated with increase morbidity and mortality, iength of stay in hospital and cost of care. Antibiotic prophylaxis use is addressed to reduce incidence of surgical site infection. The aim of this research was to find out the pattern of antibiotic prophylaxis use; incidence of surgical site infection; association between antibiotic prophylaxis use and incidence of surgical site infection; and other factors that influence the incidence of surgical site infection. This research was carried out in Dr. Cipto Mangunkusumo Hospital Jakarta and it was a retrospective study with cross-sectional design. A total of 220 samples had been taken proportional randomly according to the type of surgery division from 1,841 medical records in 2005. The result showed that the most antibiotic prophylaxis frequently used was cephalosporin (first and third generation). followed by phosphomycin and metronidazole. Most of the patients were given antibiotic prophylaxis in inappropriate time and the duration of use was more than one day. This study found that the incidence of surgical site infection was 8.6% with the highest percentage occurred at orthopedic surgery (23.3%). Statistically, there was no relationship of class. Timing and duration of antibiotic prophylaxis use with incidence of surgical site infection. Adherence of antibiotic prophylaxis use to hospital guideline was not influenced the incidence of surgical site infection. Multivariate analysis with logistic regression analysis showed that the incidence of surgical site infection were influenced by the type of surgery (OR=2.6) and the use of antibiotics during hospitalization prior to surgery (OR=3.2). The conclusion of this research were the incidence of surgical site infection relatively high and class. timing, duration and adherence to hospital guideline of antibiotic prophylaxis use did not influence it. The wound contaminated and the use antibiotics during hospitalization prior to surgery were risk factors for surgical site infection. It was recommended that the hospital management revise the currently used surgical antibiotic prophylaxis guideline which is no longer relevant to the current situation."

"A research had been performed in order to get general description of the service of an oral complementary drug in the nursing ward of IRNA B of Perjan RS Dr. Cipto Mangunkusumo and it evaluated the operation of the oral complementary drug service was and also found out the correlation of the orderly medication instruction writing of the oral complementary drug, the orderly operation of the process of th oral complementary drug procurement, drug preservation, drug preparation, the handover the oral complementary drug to a patient, and communication, information and education (CIE) in the nursing ward of IRNA B relation to the orderly operation of oral complementary drug service prosedure. The research used the cross sectional method of survey which was descriptive and analytic in its nature. The research showed that 74.81% of the patients medication instruction writing in prescription did not fit the requirements in administration writing and medication information completely 7.94% of the patients bought the prescription (76%-1005) form the drug store in RSCM, 42.75% of patients kept the 76%-100% of their drug in the pharmacy depot, 42.75% prepared the 76%-100% of patient prepared the 76%-100% of their drug in unites of doses by the pharmacy depot. 64.12% of the patients were given their drug by nurses directly, and finished to swallow the drug according to its use direction, and there was none of the patients who got CIE service from a pharmacist. The operation of the oral complementary drug service in the nursing wawrd of IRNA B was evaluated as less appropriate to the procedure. It could be concluded that there is significant correlation between medication instruction writing, the orderly operation of the process of the oral complementary drug preservation, the drug preparation, the had-over the oral complementary drug to a patient in the nursing ward of IRNA B with the orderly operation of oral complementary drug service procedure; and there is no correlation between the procurement of the oral complementary drug, the orderly operation of CIE in the nursing ward of IRNA B with the orderly operation of oral complementary drug service procedure."