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"Contents : Establishing the need : why human milk is important to a nation’s public health -- Implementing NICU breastfeeding support: policies and procedures: step 1 -- Step 2 : staff training for improved skills and competency in assisting breastfeeding mothers -- Step 3 : informing mothers of preterm infants about the need for their milk -- Step 4 : helping preterm mothers mother through increased mother-infant contact -- Step 5 : establishing and maintaining a milk supply for the NICU infant -- Step 6 : give preterm and/or compromised infants only human milk unless medically contraindicated -- Step 7 : implementing kangaroo mother care and skin-to-skin contact in the NICU as routine care -- Step 8 : transitioning the baby to full breastfeeding -- Sept 9 : addressing issues of conflict of interest -- Step 10 : the role of the NICU in providing breastfeeding support -- Use of banked donor human milk as an alternative to formula -- U.S. milk banking : a century of safety -- International practices and policies in donor human milk banking -- The ten steps for a baby-friendly milk bank -- The ethics of human milk use in the NICU."

"Latar Belakang: Air susu ibu (ASI) merupakan asupan yang direkomendasikan pada semua bayi baru lahir. ASI pada bayi yang menjalani perawatan intensif diberikan dalam bentuk ASI perah (ASIP). Akan tetapi, berbagai penelitian menunjukkan bahwa serangkaian proses persiapan ASIP merupakan sumber kontaminasi dan penularan infeksi. Infeksi pada bayi baru lahir merupakan salah satu masalah serius yang belum terpecahkan dalam perawatan bayi baru lahir, termasuk pada Rumah Sakit Cipto Mangunkusumo (RSCM). Meskipun alur pengelolaan ASIP yang digunakan sudah sesuai dengan standar WHO, belum pernah dilakukan evaluasi terhadap kejadian kontaminasi ASIP sebelumnya.Tujuan: Mengetahui angka kejadian kontaminasi ASIP di Rumah Sakit Cipto Mangunkusumo dan faktor-faktor yang memengaruhinya.Metode: Dilakukan penelitian potong lintang terhadap 60 sampel ASIP di divisi Neonatologi Departemen Ilmu Kesehatan Anak (IKA) Fakultas Kedokteran Universitas Indonesia (FKUI) - Rumah Sakit Cipto Mangunkusumo (RSCM) pada bulan Desember 2018 hingga Januari 2019. Sampel penelitian merupakan ASIP yang didapatkan dari proses pemerahan oleh ibu dengan bayi yang dirawat di ruang perawatan Neonatal Intensive Care Unit (NICU) RSCM. Ibu dengan riwayat penyakit yang menular lewat ASI, mengalami mastitis, atau sedang mengonsumsi antibiotik dan probiotik dieksklusi dari penelitian. Dilakukan pemeriksaan kultur terhadap ASIP sebanyak dua kali yaitu pertama kali maksimal dua jam setelah ASI diperah dan kedua kali setelah disimpan di lemari pendingin dengan suhu <4oC selama 48 jam, selesai dilakukan pemrosesan dan siap diberikan pada bayi.Hasil: Didapatkan hasil angka kontaminasi ASIP di NICU RSCM adalah sebesar 66,67%. Profil kuman terbanyak sebagai kontaminan ASIP di NICU RSCM adalah Staphyloccocus epidermidis (ASIP setelah diperah 46,7%, ASIP sebelum pemberian 40%), Acinetobacter baumanii (ASIP setelah diperah 18,3%, ASIP sebelum pemberian 16,7%) dan Staphylococcus haemolyticus (ASIP setelah diperah 13,3%, ASIP sebelum pemberian 6,7%). Faktor risiko yang berpengaruh terhadap kontaminasi ASIP di NICU RSCM diantaranya adalah tindakan cuci tangan ibu sebelum memerah ASI dan penggunaan masker oleh petugas saat memproses ASIP untuk bayi.

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Background: Breast milk is the recommended nutrient for every newborn. Newborn in neonatal intensive care unit is also provided in form of expressed breast milk. However, various studies have shown that expressed breast milk preparation is prone to contamination and infection transmission. Infection in newborn is a serious problem which has not been solved in newborn care, including in Cipto Mangunkusumo National Hospital (CMH). In spite of its expressed breast milk process correspond with World Health Organization guideline, evaluation has never been thouroughly done for expressed breast milk contamination rate.

Objective: To investigate expressed breast milk contamination rate in Cipto Mangunkusumo National Hospital and its affecting factors

Method: Cross sectional study was done to 60 expressed breast milk samples in Neonatology division, Child Health Department, Faculty of Medicine Universitas Indonesia (FKUI) - Cipto Mangunkusumo National Hospital (CMH) on December 2018 to January 2019. Samples for the study were expressed breast milk taken from mother whose baby was admitted to Neonatal Intensive Care Unit (NICU) of CMH. Mothers with breast milk transmission infection, having mastitis, or consuming antibiotic or probiotic were excluded from the study. Culture from samples was done two times, the first time was at maximum of two hours after breast milk was expressed and the second time was after the breast milk had been stored in freezer with temperature below 4o Celsius for 48 hours, processed, and ready to be taken by newborn.

Result: It is shown that the contamination rate of expressed breast milk in NICU of Cipto Mangunkusumo Hospital was 66,67%. Most prevalent bacteria for expressed breast milk contaminant were Staphylococcus epidermidis (1st sampling 46,7% , 2nd sampling 40%), Acinetobacter baumanii (1st sampling 18,3%, 2nd sampling 16,7%), and Staphylococcus haemolyticus (1st sampling 13,3%, 2nd sampling 6,7%). Risk factors affecting expressed breast milk contamination in NICU of Cipto Mangunkusumo Hospital were mother handwashing before breast milk expression and the use of mask for officers processing expressed breast milk."

"Bayi membutuhkan ASI sebagai makanan tunggal terbaik pada enam bulan pertama kehidupan. Lemak dalam ASI menyumbang bagian terbesar energi bayi yang dipengaruhi berbagai faktor, termasuk faktor ibu. Penelitian potong lintang ini dilaksanakan untuk mencari korelasi antara kadar lemak ASI dengan komposisi tubuh dan asupan energi dan zat gizi makro pada 48 orang ibu menyusui di RSIA Budi Kemuliaan Jakarta. Penelitian ini tidak menemukan adanya korelasi yang bermakna antara kadar lemak ASI dengan massa lemak tubuh, cairan tubuh total, massa otot, serta asupan energi, lemak, karbohidrat, protein, dan air.

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The infant needs breast milk as the best sole food for the first sixth month of life. Breast milk fat content accounted for the largest part of infant energy that influenced by many factors, including maternal factor. This cross-sectional study was conducted to find correlation between the breast milk fat content and maternal body composition, and also energy and macronutrient intake among 48 nursing mothers in RSIA Budi Kemuliaan, Jakarta. This study did not find significant correlation between the fat content of breast milk and body fat, total body water, muscle mass, intake of energy, fat, carbohydrate, protein, and water."

"[ABSTRAKLatar Belakang: Ketrampilan menghisap dan koordinasi antara menghisap, menelan dan bernafas belum adekuat belum adekuat pada neonatur prematur. Neonatal Oral-Motor Assessment Scale (NOMAS) adalah alat ukur yang telah sahih dan andal dalam menilai oromotor skill pada neonatus prematur. Penelitian ini ingin menguji validitas isi dan reliabilitas interrater dan test-retest yang diterjemahkan kedalam bahasa Indonesia yang belum pernah dilakukan sebelumnya.Metode : Desain penelitian ini adalah uji validasi, terdiri dari 16 subjek yang diambil berdasarkan kriteria penerimaan; neonatus prematur, kondisi umum stabil dan diizinkan oleh orang tua dengan mengisi informed consent. Data berupa video saat menyusu diawali dari saat pertama bertemu peneliti hingga usia koreksi 40 minggu. Oromotor skill dinilai dengan NOMAS yang telah diterjemahkan ke bahasa Indonesia. Validitas isi dilakukan dengan proses non-statistik; keandalan intrarater dinilai dengan uji Cohen?s Kappa dan Inter Class Correlation, keandalan interrater dengan uji Cronbach Alpha dan Inter Class Correlation.Hasil : Dari 16 neonatus didapatkan usia gestasi 32-35 minggu dan BBLR 93,75%. Secara isi NOMAS berbahasa Indonesia telah dinyatakan sesuai dengan NOMAS berbahasa Inggris. Keandalan intrarater bernilai baik hingga sempurna (K= 0,6-1,00 dan ICC= 0,4-1,00). Uji keandalan interrater bernilai rendah hingga hampir sempurna (Cronbach?s Alpha = 0,18-0,84 dan ICC= 0,05- 0,80).Kesimpulan : NOMAS berbahasa Indonesia mempunyai validitas isi dan reliabilitas yang baik untuk digunakan sebagai alat ukur oromotor skill pada neonatus prematur. Sebaiknya mengikuti pelatihan NOMAS agar lebih mengusai penggunaan alat ukur ini.

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ABSTRACTBackground : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach?s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure., Background : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach’s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure.]"

"Tesis ini membahas tentang analisis kebutuhan tenaga dokter umum berdasarkan beban kerja di Instalasi Gawat Darurat RSUD Leuwiliang Kabupaten Bogor tahun 2014. Penelitian ini adalah penelitain deskriptif dengan analisa data kuantitatif dengan menggunakan metode work sampling, penelitian ini bertujuan untuk mengetahui jumlah kebutuhan tenaga dokter umum IGD yang sesuai dengan kegiatan sesungguhnya berdasarkan beban kerja kerjanya masing-masing. Penelitian ini dilakukan selama tujuh hari pada tanggal 16-22 Mei 2014 dengan responden dokter IGD, dimana segala aktivitasnya diamati setiap 5 menit. Hasil penelitian menunjukkan kegiatan produktif dokter IGD mencapai 83,98 %, dinilai sudah mencapai standar waktu kerja dan beban kerjanya tinggi sehingga dinilai kegiatan produktifnya sudah optimal. Dari hasil perhitungan didapatkan jumlah dokter yang dibutuhkan pada IGD RSUD Kabupaten Bogor untuk melayani pasien selama 24 jam dalam sehari adalah enam belas orang dokter. Hasil penelitian menyarankan pihak manajemen untuk merencanakan kebutuhan jumlah tenaga dokter di IGD sesuai dengan beban kerjanya.

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The intent of this thesis is to discuss an analysis of general practitioner human resource requirements based on workloads at the Intensive Care Unit of Leuwiliang State Hospital, Bogor Regency, during 2014. The research presented is descriptive research found by means of analysing quantitative data using a work sampling method. This research proposes to to discern the number of general practitioners required at the ICU, based on actual individual workloads. The research was conducted over a period of seven days, from 16 - 22 May, 2014. The subjects were ICU doctors, whose activities were observed at five-minute intervals.

The results of this research indicate that doctors have 83.98% workplace productivity, which is understood as being a standard rate of performance when completing heavy workloads, and therefore an optimal level of workplace productivity. Calculations applied to this research show that the number of doctors working 24-hours shifts needed at the Bogor Regency State Hospital ICU to attend to patients is sixteen. The results of this research suggest that management should assign general practitioner human resources to ICUs according to workloads."

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Karya ilmiah akhir ini membahas tiga topik besar dalam keperawatan selama melaksanakan praktik residensi ners spesialis keperawatan. Pertama membahas asuhan keperawatan pasien gagngguan kardiovaskular dengan pendekatan teori Keperawatan Lydia E Hall (care, core dan cure), kedua membahas hand massage sebagai intervensi  berbasis bukti untuk mengatasi nyeri pada pasien bedah jantung, ketiga membahas inovasi Keperawatan untuk mendeteksi dini risiko infeksi pasien bedah jantung. Penelitian ini menggunakan pendekatan studi kasus. Hasil penelitian menyarankan bahwa teori Hall menjadi rujukan ilmu keperawatan pada penerapan asuhan keperawatan pasien gangguan kardiovaskular, menjadikan hand massage alternatif intervensi berbasis bukti untuk nyeri dan menerapkan sistem penilaian untuk mengidentifikasi pasien yang memiliki resiko tinggi mengalami infeksi luka sternum

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This final scientific work discusses three major topics in nursing while implementing specialist nursing residencies. The first discusses nursing care for patients suffering from cardiovascular disorders with Lydia E Hall Nursing theory approach (care, core and cure), the second discusses hand massage as evidence-based interventions for pain relief in cardiac surgery patients, the third discusses Nursing innovations to detect early risks of infection of cardiac surgery patients. This research uses a case study approach. The results suggest that Hall's theory is a reference for nursing in the application of nursing care for cardiovascular disorders, hand massage as an alternative evidence-based intervention for pain, and applies a scoring system to identify patients at high risk of developing a sternum wound infection.

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"The Objectives of this study were to determine cadmium and lead concentration in the breas milk of healthy lactating women who were living in Zarrinshar, an industrial area of Iran and to investigate the effect of mother's age, parity and smoking habits in families living in the vacinity of areas contaminated with heavy metals."

"Perawatan metode kanguru (PMK) dapat digunakan dalam merawat bayi berat lahir rendah (BBLR). Tujuan penelitian ini untuk mengetahui pengaruh perawatan metode kanguru terhadap pertumbuhan bayi, pengetahuan dan sikap ibu dalam merawat BBLR di RSUD Cibabat-Cimahi. Desain penelitian yang digunakan quasi experiment. Sampel penelitian terdiri atas 16 orang kelompok kontrol (tanpa PMK) dan 16 orang kelompok intervensi (PMK), yang diambil secara consecutive sampling.Hasil penelitian menunjukkan tidak ada perbedaan yang signifikan dalam pertumbuhan bayi antara kelompok intervensi dan kelompok kontrol. Terdapat perbedaan yang signifikan pada pengetahuan dan sikap ibu pada kedua kelompok. Rekomendasi untuk penelitian lebih lanjut agar dilakukan teknik PMK secara continue dan intermiten.

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Kangaroo Mother Care (KMC) can be used in the care of low birth weight (LBW). The purpose of this study is to determine the effect of KMC on the growth of infants, knowledge and attitudes of mothers in caring for LBW in Cibabat Hospital. The study design used was quasi experiment. The samples in this study were 16 infants and mother in control group (without KMC) and 16 infants and mother in intervention group (KMC). Samples were taken by consecutive sampling.

The results showed that there were no significant differencies in the growth of infants between control and intervention groups. There were a significant differencies of knowledge and attitudes of mother at two group. Recommends further research with continuous and intermittent classifying of KMC."