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"Thoroughly revised and updated for its Fourth Edition, a comprehensive reference on hospital epidemiology and infection control. Written by over 150 leading experts, this new edition examines every type of hospital-acquired (nosocomial) infection and addresses every issue relating to surveillance, prevention, and control of these infections in patients and in healthcare workers. This new edition features new or significantly increased coverage of emerging infectious diseases, avian influenza, governmental regulation of infection control and payment practices related to hospital-acquired infections, molecular epidemiology, the increasing prevalence of community-acquired MRSA in healthcare facilities, system-wide infection control provisions for healthcare systems, hospital infection control issues following natural disasters, and antimicrobial stewardship in reducing the development of antimicrobial-resistant organisms."

"Healthcare Associated Infections (HAIs) merupakan peristiwa buruk yang paling sering terjadi dalam pelayanan kesehatan di seluruh dunia. Setiap tahunnya terdapat ratusan juta pasien terkena HAIs yang mengarah pada kematian secara signifikan dan menyebabkan kerugian finansial untuk sistem kesehatan. Di negara-negara berpenghasilan menengah dan rendah, frekuensi infeksi di ICU setidaknya 2-3 kali lebih tinggi daripada negara-negara berpenghasilan tinggi. Tujuan dari penelitian ini adalah mendapatkan hasil analisis tata laksana pencegahan dan pengendalian Health care-associated infections (HAIs) di unit perawatan intensif RSUD Koja menggunakan metode bow tie. Penelitian ini merupakan jenis penelitian operasional yang bersifat kualitatif. Metode yang digunakan adalah wawancara mendalam, telaah dokumen, dan observasi. Hasil penelitian ini menunjukkan bahwa penyebab angka HAIs di RSUD Koja masih diatas standar yakni adanya latent failure dalam upaya pencegahan dan pengendalian HAIs. Maka dari itu diperlukan perbaikan dalam beberapa variabel laten untuk memaksimalkan upaya pencegahan dan pengendalian HAIs, serta dibutuhkan penelitian yang membahas kondisi pasien sebagai ancaman dalam upaya pencegahan dan pengendalian HAIs di rumah sakit.

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Healthcare Associated Infections (HAIs) are the most frequent adverse events in health services throughout the world. Every year there are hundreds of millions of patients affected by HAIs that lead to death significantly and cause financial losses to the health system. In middle and low-income countries, the frequency of infections in ICUs is at least 2-3 times higher than in high-income countries. The purpose of this study was to obtain the results of analysis of prevention and control of Health care-associated infections (HAIs) in the intensive care unit at Koja Disrict Hospital using the bow tie method. This research is a type of operational research that is used qualitative method. The methods used are in-depth interviews, document studies, and observations. The results of this study indicate that the cause of the number of HAIs in Koja District Hospital is still above the standard, namely the presence of latent failure in efforts to prevent and control HAIs. Therefore, improvements in some latent variables are needed to improve the effectiveness of HAIs prevention and control efforts, and research is needed to discuss the patients condition as a threat in preventing and controlling HAIs in the hospital."

"Intensive care is a rapidly changing area of medicine, and after four years from the 2nd edition the volume editors and authors have deemed necessary to update it. In the recent years, in fact, five new randomised controlled trials and five new meta-analyses demonstrate that selective decontamination of the digestive tract [SDD] is an antimicrobial prophylaxis to prevent severe infections of not only lower airways but also of blood. Additionally, SDD has been shown to reduce inflammation including multiple organ failure and mortality. An intriguing observation is the evidence that SDD using parenteral and enteral antimicrobials reduces rather than increases antimicrobial resistance. Moreover, a new chapter on microcirculation had been added."

"Kepala ruangan mempunyai peran penting, dalam upaya mendukung program Pencegahan dan Pengendalian Infeksi (PPI) di Rumah sakit. Kompetensi kepala ruangan dalam pencegahan dan pengendalian infeksi (ppi) merupakan kompetensi dasar yang harus dimiliki. Kemampuan yang dimiliki di pengaruhi faktor karakteristik, motivasi diri dan suvervisi kepala ruangan. Metode penelitian ini, menggunakan pendekatan kuantitatif dengan desain Cross-sectional. Pengambilan sampel dengan teknik total sampling dengan jumlah sampel 70 kepala ruangan di empat (4) Rumah sakit wilayah Bogor. Hasil penelitian menggunakan uji chi-square dengan CI 95%, didapatkan hasil bahwa terdapat hubungan signifikan antara jenjang karir (p-value 0.030), Motivasi Diri (p-value 0.015), Supervisi kepala ruangan (p-value 0.001) dan kemampuan pengendalian dan pencegahan infeksi kepala ruangan. Tidak terdapat hubungan antara usia (p-value 0,414), tingkat Pendidikan (p-value 0,069), jenis kelamin (p-value 0,314), lama bekerja (p-value 0,854), pelatihan PPI (p-value 0,896) dan kemampuan pencegahan dan pengendalian infeksi (ppi) kepala ruangan. Hasil regresi logistik berganda didapatkan supervisi kepala ruangan menjadi variabel paling dominan. Simpulan dalam penelitian ini adalah pentingnya kepala ruangan dalam peningkatan jenjang karir, melakukan supervisi dan memiliki motivasi diri baik, dalam optimalisasi program pengendalian dan pencegahan infeksi

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The head of the room has an important role, in an effort to support the Infection Prevention and Control program in the hospital. The competence of the head of the room in infection prevention and control is a basic competency that must be possessed. The abilities possessed are influenced by characteristic factors, self-motivation and supervision of the head of the room. This research method uses a quantitative approach with a cross-sectional design. Sampling with total sampling technique with a sample of 70 heads of rooms in four (4) hospitals in the Bogor area. The results of the study using the chi-square test with 95% CI, the results showed that there was a significant relationship between career path (p-value 0.030), self-motivation (p-value 0.015), supervision of the head of the room (p-value 0.001) and controllability and prevention of head room infection. There is no relationship between age (p-value 0.414), education level (p-value 0.069), gender (p-value 0.314), length of work (p-value 0.854), PPI training (p-value 0.896) and prevention skills. and infection control (ppi) head of the room. The results of multiple logistic regression showed that the supervision of the head of the room was the most dominant variable. The conclusion in this study is the importance of the head of the room in increasing career paths, supervising and having good self-motivation, in optimizing infection control and prevention."

"Kinerja perawat dalam melaksanakan pencegahan dan pengendalian infeksi (PPI) belum maksimal. Hal ini terjadi di beberapa negara khususnya negara berkembang termasuk Indonesia. Fenomena ini disebabkan oleh pelaksanaan peran kepala ruangan yang belum optimal dan perlu ditingkatkan. Penelitian ini dilaksanakan untuk mengidentifikasi hubungan peran figure head dengan kinerja perawat dalam PPI di rumah sakit. Penelitian ini menggunakan metode penelitian Cross Sectional dan regresi logistik. Penelitian dilaksanakan rumah sakit Kalimantan Barat dengan sampel 203 perawat. Analisis data menggunakan Chi Square dan Regresi Logistik. Hasilanalisis menunjukkan sub peran yang memiliki hubungan signifikan yaitu persepsi terhadap figure head (p=0.014, CI 95%; 1.195-5.952). Peran leader memiliki hubungansignifikan(p=0.022, CI 95%; 0.186-0.894), namun berdampak negatif terhadap kinerja. Faktor yang paling berpengaruh adalah figure head (OR. 3.358). Kinerja perawat dalam PPI di rumah sakit dapat ditingkatkan dengan mengoptimalkan peran figure head kepala ruangan.

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The job performance of nurses in implementing infection prevention and control has not optimal. These happened in several countries, especially developing countries, including Indonesia. These phenomena is caused managers role that has not optimal. Figure head role by manager isimportant to improve nurse infection and prevention control performance. The nurses need role model to improve their perforance. This study was conducted to identify the relationship between the figure head role of manager and the performance of nurses in infection and prevention control program in hospitals. This researchs design uses quantitative cross sectional study. The studywas conducted at one of rural hospital at West Borneo with 203 nurses sample. Data analysis using Chi Square and multiple logistic regression. The sub role that has a significant relationship to infection and prefention control is figure head (p = 0.014.95% ci; 1.195-5.952) and the nurses to of the leader (p = 0.022.95% ci; 0.186-0.894). The most influential factor is the figure head (or 3.358). Nurse performance in infection control can be good by improving figure head role of nurse unit manager."

"Bennett &​ Brachman Hospital Infections has been an influential textbook on nosocomial infections for over 30 years. This book provides readers with the latest information in the field of healthcare epidemiology and hospital accumulated infections prevention and control."

"ABSTRAKKepala ruang berkontribusi dalam pelaksanaan pencegahan dan pengendalian infeksi PPI di ruang rawat, tetapi kenyataannya masih belum melakukan peran dan fungsinya dalam PPI. Penelitian ini bertujuan mengetahui pengaruh penguatan peran dan fungsi karu terhadap pelaksanaan pencegahan dan pengendalian infeksi di Rumah Sakit RS . Metoda yang digunakan adalah dengan desain kuasi eksperimen. Responden terdiri dari 5 kepala ruang, dan 34 perawat pelaksana dari kelompok intervensi dan kontrol. Hasil penelitian menunjukkan ada pengaruh yang signifikan penguatan peran dan fungsi karu terhadap kepatuhan pelaksanaan PPI antara kelompok intervensi dan kelompok kontrol p 0,03; ? 0,05 . Rekomendasi Penguatan peran dan fungsi karu diharapkan mendapatkan dukungan dari manajemen keperawatan, kepala ruang dan pelaksana pelayanan untuk meningkatkan kepatuhan perawat terhadap pelaksanaan PPI sebagai dasar meningkatkan mutu pelayanan keperawatan di RS.

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ABSTRACTThe head nurses should contribute to the implementation of prevention and infection control PPI in the ward, but in reality still has not performed its role and function in PPI. This study aims to determine the effect of strengthening the role and function of head nurses on the implementation of infection prevention and control in hospitals RS . The method used is Quasi experiment design. Respondents consisted of 5 headsnurse, and 34 nurses from the intervention and control group. The result of the research shows that there is a significant influence of the strengthening of role and function of head nurseson compliance of PPI implementation p 0,03 0,05 . Recommendations Strengthening the role and function of head nurses is expected to get support from the management of nursing, head nurses and implementing services to improve the compliance of nurses to the implementation of PPI as a basis to improve the quality of nursing services in hospitals."

"Latar Belakang : Gangguan fungsi defeksi, yang diketahui sebagai sindrom Low Anterior Resection (LARS) menjadi masalah utama paska pembedahan kanker rektum yang akan berpengaruh pada kualitas hidup. Studi ini bertujuan untuk menngetahu insidens LARS pada pasien paska prosedur preservasi sfingter ani dan faktor- faktor yang mempengaruhi LARS.Metode : Pasien kanker rektum yang menjalani eksisi total mesorektal dan anastomosis colorectal selama periode 2017-2018 berpartisipasi dalam pengisian kuesioner LARS. Parameter klinis yang dianalisis dan untuk perbandingan fisiologi anorektal antara mayor LARS dan no LARS atau minor LARS menggunakan pengukuran biofeedback.Hasil: Studi ini melibatkan 40 pasien, mayor LARS didapatkan pada 42,5% pada pasien yang menjalani low anterior resection (LAR). Radioterapi preoperatif dan level anastomosis berhubungan dengan major LARS dengan odd ratio 0,1 (95% CI : 0,02- 0,49) and 0,07 (95% CI 0,01- 0,39). Dilakukan penghitungan luasan dibawah kurva (AUC) dengan cara receiver operating characteristic (ROC) sebesar 0,77 dan didapatkan titik potong level anastomosis di 5 cm dengan nilai ramal negative 88,23%. Pengukuran biofeedback menunjukkan perbedaan signifikan pada tekanan anal istirahat (resting anal pressure) dan tekanan kontraksi maksimal (maximal squeeze pressure) diperkirakan terjadi gangguan pada fungsi sfingter dan terapi preoperatif berperan untuk terjadinya LARS.Kesimpulan: LARS merupakan masalah signifikan yang diteukan pada hampir sepertiga pasien kanker rektum paska pembedahan. Resiko terkena mayor LARS meningkat dengan adanya terapi preoperatif dan rendahnya level anastomosis.

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Background : Defective defecation n function, also known as low anterior resection syndrome (LARS), is common problem after surgical treatment of rectal cancer that has a detrimental effect on quality of life. This study aimed to look for the incidence of LARS in patients whose native rectum could not be kept and determine factors influencing major LARS.

Methods : Retal cancer patients who underwent tumor removal with mesorectal excision and colorectal anastomosis during the years 2017-2018 were asked to participate a structured interview using the verified version of the LARS questionnaire. Clinical parameters were analyzed and anorectal physiology was compared between those with major LARS and those without LARS by biofeedback measurement.

Results : This study included 40 patients ,major LARS was found at 42,5% in those who underwent low anterior resection , which incidence 22% than other group. Preoperative radiotherapy and level of the anastomosis associated with major LARS at an odd ratio 0,1 (95% CI : 0,02- 0,49) and 0,07 (95% CI 0,01- 0,39). The receiver operating characteristic curve showed an area under the curve of 0,77. The cut-off anastomotic level was at 5 cm, which gave a negative predictive value of 88,23%. Biofeedback measurement showed a significant difference in the resting anal pressure and maximal squeeze pressure, which suggests that dearrangement in sphincteric function and preoperative therapy may contribute to the LARS.

Conclusion : LARS is significant problem found in about one third of rectal patients after surgery. Risk of having major LARS increases with preoperative treatment and lower anastomotic level."

"Infeksi yang berhubungan dengan perawatan kesehatan atau infeksi yang diperoleh dalam perawatan kesehatan adalah efek samping yang paling umum dalam penyediaan layanan kesehatan di seluruh dunia. Rumah sakit bertujuan untuk memberikan perlindungan bagi keselamatan pasien, masyarakat, lingkungan rumah sakit dan sumber daya manusia di rumah sakit dan meningkatkan kualitas dan mempertahankan standar layanan rumah sakit. Program Pencegahan dan Pengendalian Infeksi (PPI) adalah upaya untuk memastikan perlindungan setiap orang dari kemungkinan tertular infeksi dari sumber- sumber publik dan saat menerima layanan kesehatan di berbagai fasilitas kesehatan. Tujuan penelitian ini adalah untuk menganalisis implementasi program pencegahan dan pengendalian infeksi di RSUP Persahabatan Jakarta. Desain penelitian adalah kualitatif dengan menggunakan metode wawancara mendalam terstruktur, telaah dokumen serta observasi dengan memakai lembaran observasi.Hasil penelitian menunjukkan bahwa Sumber Daya Manusia masih kurang, sarana dan prasarana belum berkesinambungan dibeberapa unit layanan, kepatuhan kebersihan tangan di kalangan peserta didik masih rendah, laporan mengenai infeksi daerah operasi masih belum optimal dan pencatatan serta pelaporan kegiatan program PPI belum disampaikan ke Kementerian Kesehatan.Implementasi program PPI di rumah sakit membutuhkan dukungan SDM, sarana prasarana yang berkesinambungan terutama untuk sarana prasarana kebersihan tangan, edukasi yang intens terhadap peserta didik dan karyawan rumah sakit akan kepatuhan kebersihan tangan dan sistem pencatatan dan pelaporan kegiatan PPI sesuai aturan yang ada.

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Infections related to healthcare or infections acquired in healthcare are the most common side effects in the provision of health services worldwide. The hospital aims to provide protection for the safety of patients, the community, the hospital environment and human resources in hospitals and improve the quality and maintain standards of hospital services. Infection Prevention and Control (IPC) is an effort to ensure the protection of everyone from the possibility of contracting infection from public sources and when receiving health services in various health facilities.The purpose of this study was to analyze the implementation of infection prevention and control in RSUP Persahabatan Jakarta. The research design is qualitative using in-depth structured interview method, document review and observation using observation sheets. The results showed that human resources were still lacking, facilities and infrastructure had not been sustainable in some service units, compliance with hand hygiene among students was still low, reports of infection in operating areas were still not optimal and recording and reporting of PPI activities had not been submitted to the Ministry of Health. The implementation of PPI in hospitals requires the support of human resources, sustainable infrastructure, especially for hand hygiene infrastructure, intense education for students and hospital employees for compliance with hand hygiene and a system for recording and reporting PPI activities according to existing regulations."