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"Dalam menjalankan sistem INA-CBG's pihak rumah sakit harus membangun komunikasi yang baik antara tim dokter, petugas koding serta manajemen untuk mengurangi variasi pelayanan dan pilih layanan yang paling cost efective dengan membuat dan menjalankan Clinical Pathway serta mengedepankan kendali mutu dan kendali biaya, untuk menghasilkan pelayanan yang bermutu. Data dari Rumah Sakit Anisa Citeureup Bogor menunjukkan bahwa rata-rata biaya pelayanan kesehatan dengan diagnosa DHF demam berdarah lebih besar dari rata-rata dari paket INA-CBG. Ini bisa menjadi kerugian untuk rumah sakit. Untuk meningkatkan efisiensi dan mutu dalam memberikan pelayanan kesehatan, maka perlu dikembangkan media untuk membantu klinisi dalam memberikan informasi untuk mendukung keputusannya dalam memberikan pelayanan kesehatan dalam bentuk penerapan Clinical Pathway yang terintegrasi dengan rencana pelayanan kesehatan dan berisi semua langkah yang dilakukan oleh pasien dari masuk rumah sakit sampai keluar dari rumah sakit. Berdasarkan informasi tersebut, maka aplikasi dapat menjadi solusi untuk mengakomodasi permasalahan tersebut dan dapat menjadi pembanding antara Clinical Pathway yang akan diterapkan di Rumah Sakit Annisa dengan INA-CBG's yang diterapkan pemerintah. Tujuan dari penelitian ini adalah untuk menganalisa dan membuat perancangan aplikasi clinical pathway berdasarkan sistem INA-CBG, dengan menggunakan pendekatan sistem pada Rumah Sakit Anisa Citeureup Bogor.

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In running the INA CBG system, hospitals should establish good communication between doctors, coding and management staff to reduce service variation and select the most cost effective services by creating and operating the Clinical Pathway and promoting quality control and cost control to produce services Quality. Data from Anisa Citeureup Bogor Hospital showed that the average cost of health services with DHF diagnostics dengue was greater than the average of the INA CBG package. This could be a disadvantage for the hospital. To improve the efficiency and quality in providing health services, it is necessary to develop media to assist clinicians in providing information to support their decision in providing health services in the form of Clinical Pathway application integrated with health service plan and contains all steps taken by the patient from hospital admission Got out of the hospital. Based on the information, the application can be a solution to accommodate the problem and can be a comparison between Clinical Pathway to be applied at Annisa Hospital with INA CBG 39 s applied by the government. The purpose of this research is to analyze and make the application of clinical pathway application based on INA CBG system, using system approach at Anisa Citeureup Bogor Hospital."

"Demam Berdarah Dengue (DBD) adalah merupakan masalah kesehatan di Indonesia sejak tahun 1968 sampai sekarang. Ada beberapa daerah yang sudah ada penurunan tetapi sebagian wilayah Indonesia malah dari tahun ke tahun terus meningkat angka kesakitan penyakit ini. Di Kabupaten Bandung selama 3 tahun terakhir dari tahun 2011 sampai 2013 angka kesakitan DBD terus meningkat yaitu sebesar 1078 tahun 2011, 1127 tahun 2012 dan tahun 2013 1240 penderita. Permasalahan peningkatan penderita disebabkan banyak kendala atau permasalahan salah satunya adalah lemahnya sistem kewaspadaan dini terhadap KLB DBD. Deteksi Dini KLB DBD adalah suatu sistem pemantauan wilayah setempat yang bisa mendeteksi peningkatan kasus disuatu wilayah berdasarkan katagori KLB yang tertuang di dalam Permenkes No. 1501 Tahun 2010 Tentang Jenis Penyakit Menular Tertentu Yang Dapat Menimbulkan Wabah dan Upaya Penanggulangan. Penelitian dilakukan menggunakan desain penelitian kualitatif dengan menerapkan pendekatan model prototyping dalam membangun model sistem informas kesehatan. Penelitian ini menghasilkan rancangan basis data dan desain prototype dari sistem informasi kesehatan penyakit demam berdarah dengue dengan deteksi dini KLB DBD di Dinas Kesehatan Kabupaten Bandung, sehingga deteksi awal kejadian luar biasa penyakit demam berdarah dengue bisa diketahui pada saat melakukan input data sebelum pengolahan data untuk pembuatan laporan Kabupaten Bandung.

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Dengue Hemorrhagic Fever (DHF) is a health problem in Indonesia since 1968 until now. There are several existing areas decreased but parts of Indonesia, even from year to year increase in morbidity of this disease. In Bandung District during the last 3 years from 2011 to 2013 number of DHF cases continue to rise in the amount of 1078 in 2011, 1127 in 2012 and 1240 of 2013 patients. Problems caused an increase in patients with many obstacles or problems one of which is the lack of an early warning system against dengue outbreak. Early detection of outbreaks of dengue fever is a local area monitoring system that can detect an increase in cases of outbreaks in a region based on the categories set out in the Minister Regulation No. 1501 Year 2010 Concerning Certain Communicable Disease Type Potential Outbreak and Response Efforts.

The study was conducted using qualitative research design with prototyping models approach in building models health information system. This research resulted in the design of the database and prototype design of health information systems dengue fever with early detection of dengue outbreak in Bandung District Health Office, so that early detection of outbreaks of dengue fever can be known at the time of the input data before data processing for the manufacture of report Bandung district."

"Penelitian ini membahas tentang evaluasi implementasi clinical pathway pada penyakit Dengue Hemorrhagic Fever anak di RSUP Fatmawati tahun 2016. Tujuan dari penelitian ini adalah untuk mendapatkan evaluasi input, proses, dan outcome implementasi clinical pathway pada kasus Dengue Hemorrhagic Fever anak serta mengetahui hambatannya. Jenis penelitian ini adalah kuantitatif dan kualitat if dengan menggunakan operational research dengan metode observasi, wawancara mendalam dan terstruktur. Hasil penelitian didapatkan pengisian clinical pathway pada pasien DHF anak bulan Januari-Juni 2016 sebesar 55,15%. Format clinical pathway DHF anak sudah ringkas dan jelas namun belum lengkap dengan kriteria hasil. Belum optimalnya sosialisasi SPO, edukasi clinical pathway, serta imbalan dan sanksi. Formulir clinical pathway selalu tersedia di ruang rawat inap. Terdapat beberapa masalah dalam proses implementasi clinical pathway yaitu tidak adanya pengisian clinical pathway di IGD atau ruang lain, belum optimalnya kolaborasi antar tenaga kesehatan, belum adanya monitoring dan evaluasi untuk meningkatkan kepatuhan dan kelengkapan pengisian clinical pathway. Evaluasi outcome dari implementasi clinical pathway DHF anak yaitu terdapat variasi pada lama hari rawat 12%, pemeriksaan penunjang DTL, Urine, Feses 99 %, Anti Degue, IgG/IgM 6%, pemeriksaan CXR RLD 55%, gizi 35%, pengobatan parasetamol 40% dan IVFD 2%.

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This research discusses the evaluation of clinical pathways implementation in children's Dengue Hemorrhagic Fever (DHF) disease at RSUP Fatmawati in 2016. This research aims to get input evaluation, process, and outcomes clinical pathways implementation in children's DHF disease and the obstacle. This is a quantitat ive and qualitative research that usen operational research with observation methodology, in-depth and structured interviews. The result shows that clinical pathways admission filling with patient in children?s DHF disease 55.15% in January-June 2016. Clinical pathway's form in children?s DHF disease are concise and clear but no outcome criteria. SPO?s socialization, clinical pathways educating, reward, and punishment are not optimum. Clinical pathway's form are always available at inpatient unit. There are some problems in the process of clinical pathways implemention, there is no filling clinical pathways in the ER (Emergency Room) or the other room, the lack of collaboration among health proffesional, no monitoring and evaluation to improve compliance and completeness of clinical pathways. Outcome evaluation of clinical pathways implementation in children's DHF are variations of length of stay 12%, DTL, Urine, Feses investigation 99 %, Anti Degue, IgG/IgM 6%, CXR RLD 55%, nutrition 35%, parasetamol treatment 40% and IVFD 2%."

"Tesis ini bertujuan mengembangkan Sistem Infomiasi Penccgahan dan Pemberantnsan penyakit Demam Berdamh berbasis wilayah yang dapat memudahkan dalam proses analisis data yang bermanfhat dalam proses monitoring dan evaluasi program di Kota Bekasi. Pengernbangan sistem dilakukan dcngan mctode .System Development LW Cycle (SDDC) yang terdiri dari tahapan analisa sistem, perancangan sistem dan ujicoba prototipe. Pengembangan dilakukan di tingkat Dinas Kesehatan Kota Bekasi. Hasil penelitian ini adalah pengembangan sistem yang menghasilkan informasi untuk pelaksanaan monitoring dan evaluasi program bennpa keluaran indilcator kepadatan, ABI, Endemilas dan Fogging sehingga dapat memberikan infcnnasi yang bermanfhat bagi para pengambil keputusan.

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This thesis focusing on the Development of Infomation System on The Prevention and Elimination of Dengue Fever based on Regions that can help the process of analyzing data for monitoring and evaluating the programme in Kota Bekasi region. The development of the system used System Development LM? Cycle (SDLC) methode that consist of Analyzing system, Designing System and prototype testing. The development was done in the Health department administration level. The result of this thesis is that the development of the system has produced the indicator output that can be use for monitoring and evaluating the programme. The indicator are the population density, the number of free mosquito-larva, Endemitas ofthe DBD case and Fogging that can be use to support the decision making process."

"Dengue Hemorrhagic Fever (DBD) has become public health problem for almost four decades. The highest case took place in DKl Jakarta than the other provinces till year 2007 which 30.703 of overall eases, 82 of mortality case, IR (378.5) and CFR (0.3). The South Jakarta is the highest ease in DKI Jakarta which are 28 of mortality case, IR (551.69), CFR (0.3), tends to increase for every years.Consequently related study of risk factors of DBD case must be took using new technology of Geographic Information System (GIS) contributed fur mapping correspond to examination, analysis. and controlling of health services. This study aimed to obtain description of epidem tology of DBD based on Geographic Information System (GIS) and related factors oi DBD case taking place in South Jakarta year 2007. Design of research uses ecological and serial of case study exploiting secondary data in Sudinkesmas, BPS Jakarta, and BMG. The data was analyzed in the manner of univariat, bivariat, multivariat and spatial. Result of research of DBD case in South Jakarta on January - December 2007 found most man hit by this case about 53,9%, partially age of 5-14 years old with 26% proportion and 15-44 years old with 55%. The highest incident rate of 64 sub-districts is Mampang Prapatan with 1225/100.000 population. While the lowest incident rate found in Pasar Minggu sub-district with 3941100.000. Generally top of epidemy happened on February and March."

"Salah satu upaya pencegahan dan pemberantasan penyakit Demam Berdarah Dengue, antara lain adalah membuat surveilans penyakit tersebut. Manfaat surveilans diantaranya adalah untuk membentuk sistem Kewaspadaan Dini terhadap letusan kasus maupun KLB (Kejadian Luar Biasa), disamping itu jugs mangatahui pola penyebaran. Penelitian terdahulu oleh peneliti lain (tahun 1998 dan 1995) di wilayah Kotamadya Bandung dan l:ndramayu, disebutkan bahwa data surveilans masih belum menghasilkan informasi secara geografis strata wilayah rawan DBD. Oleh karena itu dalam studi ini peneliti mengembangkan model untuk mendapatkan informasi wilayah rawan terhadap penyebaran DBD berdasarkan pengolahan data surveilans ke dalam bentuk Sistem Informasi Geografis. Penelitian ini menggunakan metode operational research untuk mengembangkan model prediksi penyebaran kasus Dengue berdasarkan data surveilans kasus Demam Berdarah Dengue yang sudah dikonfirmasi. Surveilans kasus pasti tersebut dihubungkan dengan variabel : ketinggian, Jalan utama, jentik dan penduduk, dibuat model menggunakan perangkat lunak ArcView setelah diperoleh formulasi hubungan antar variabel. Model dapat menghasi Ikan informasi tingkat kerawanan suatu wilayah terhadap penyebaran DBD. Pembuatan model atau disain model meliputi beberapa tahap mulai dari penelitian awal, menentukan pola hubungan kemudian memperoleh hubungan numerik model. Uji cobs model dilakukan dengan 2 cara membandingkan basil keluaran model dengan kasus yang terjadi pada bulan berikutnya dan Membandingkan basil model dengan data wilayah rawan menurut DinKes. Berdasarkan hasil ini dapat dianalisa tingkat kebenaran model yang dibuat. Hasil penelitian mendapatkan output model yaitu wilayahlKecamatan rawan di Kabupaten Bandung yang meliputi : 22 (duapulub dua) Wilayah Kecamatan sangat rawan, 17 (tujuh betas) Wilayah Kecamatan rawan dan 4 (empat) Wilayah Kecamatan tidak rawan. Analisis pengamatan urutan kronologi kasus memperlihatkan pola penyebaran kasus menuju ke arah Utara dan ke Timur dari kecamatan terjangkit sebelumnya. Hasil prediksi Kecamatan terjangkit pada bulan ke-5, semua terjadi pada wilayah rawan dan sangat rawan. Uji dengan cara ke-2 memberikan perbedaan 11% dari 43 Kecamatan yang ada. Diharapkan model ini dapat membantu Dims Kesehatan Kabupaten Bandung dalam mengendalikan penyebaran penyakit DBD.

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Build Dengue Hemorrhagic surveillance is one of the efforts to prevent and control the disease. The benefit of surveillance is to build early warning system of case outbreak. Another benefit is to find out the spreading pattern. The recent research (year 1995 - 1998) in Indramayu and Bandung municipality found that there obstacle to take advantage stratification risk area information from analysis surveillance. Due to this reason, in this research, we try to develop application of Geographic Information System (GIS) model to present surveillance information.

This research designed is operational research, develops model to predict the Dengue spreading by using the data of Dengue surveillance. Model was built by using AreView software. 4 (four) variables, i.e.: Main road, height, population density and larva, have been examined to determine the spatial relationship between case occurrence and those variables. From the model we find out the information about the risk level of Dengue spreading.

Model building consists of 3 (three) main steps, i.e. preliminary research, determining the relationship pattern, and figure out the numeric relationship of model. Model validation was done by two way, first making the comparison between the model output and the Dengue data from the next period, second comparison between the model output and risk area according to Dinkes data. From these validation could conclude the truth of the model.

From the result we conclude that there are 22 (twenty two) districts are high-risk area, 17 (seventeen) districts are medium-risk area, and 4 (four) districts are not-risk area. From the examination of subsequence cases, we have the conclusion that the Dengue spreading is northward and eastward.

All of cases in period 5 occur in the risk and high risk area predicted. And from second validation found 11% differentiation with DinKes data Hope this model will help Dinas Kesehatan Kabupaten Bandung to control the spreading of Dengue."

"Manifestasi klinis demam berdarah dengue (DBD) masih menjadi permasalahan dalam kesehatan masyarakat di Indonesia. Berdasarkan derajat keparahan DBD menurut kritera WHO 2011 terbagi atas DBD derajat I, DBD derajat II, DBD derajat III, dan DBD derajat IV. Di Indonesia insiden DBD meningkat walaupun angka kematiannya menurun, untuk itu penelitian ini bertujuan meneliti faktor-faktor yang berhubungan dengan keparahan DBD, dimana DBD derajat II, III, dan IV dikategorikan sebagai DBD parah. Penelitian cross-sectional yang menggunakan data sekunder dari studi etiologi demam akut dari delapan rumah sakit di Indonesia, didapatkan proporsi keparahan DBD sebesar 43,3%. Faktor-faktor yang berhubungan dengan keparahan DBD didapatkan faktor jenis serotipe virus DENV-2 (OR = 3,06 95%CI 1,43-6,55), DENV-3 (OR = 2,62 95% CI 1,33-5,15), faktor lama demam (OR = 1,91 95%CI 1,09-3,35), dan faktor jumlah leukosit (OR = 1,79 95%CI 1,02-3,16). Skoring didapatkan sebesar 67% kemampuan untuk memprediksi keparahan.

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Dengue hemorrhagic fever (DHF) as a clinical manifestasion of dengue infection remains a public health problem in Indonesia. According to WHO, DHF severity grade was divided into DHF I, DHF II, DHF III and DHF IV. In Indonesia, the incidence of DHF increased eventhough the mortality rate decreased. Therefore, the study aims to examine prognostic factors related to the severity of DHF, with the category of severe DHF is including DHF II, DHF III and DHF IV.

This cross-sectional study using secondary data from the Acute Febrile Illness Etiology Study of eight Hospitals in Indonesia. The result as follow, the proportion of severe DHF category is 43.3%, the prognostic factors associated with DHF severity are DENV serotype (DENV-2, OR = 3.06 95% CI 1.43 - 6.55; DENV-3, OR = 2.62 95% CI 1.33 - 5.15), day of illness (OR = 1.91 95% CI 1.09 - 3.35), and leucocyte count (OR = 1.79 95% CI 1.02 - 3.16). The scoring with contributing of DENV serotype, day of illness, and leucocyte count as prognostic factors, has only 67% ability to predict DHF severity."

"ABSTRAK Demam Berdarah Dengue (DBD) merupakan penyakit demam akut tanpa sebab yang jelas disertai bintik-bintik merah pada kulit. Karya ilmiah ini membahas asuhan keperawatan yang diberikan pada anak dengan kasus demam berdarah dengue di Teratai 3 Selatan RSUP Fatmawati. Karya ilmiah ini bertujuan untuk menggambarkan asuhan keperawatan anak dengan DBD. Salah satu masalah keperawatan yang terjadi adalah hipertermia. Tindakan keperawatan terkait hipertermia meliputi monitor suhu, peningkatan asupan cairan, penggunaan pakaian yang tipis dan menyerap keringat, tepid sponge dan kolaborasi pemberian antipiretik. Asuhan keperawatan yang diberikan berupa tepid sponge dan pemberian antipiretik untuk membantu menurunkan demam pada anak. Hasil yang didapat anak mengalami penurunan suhu tubuh sebesar rata-rata 1,1ºC setelah 30 menit pemberian tepid sponge yang disertai dengan pemberian antipiretik. Tepid sponge dapat menambah keterampilan perawat dalam menurunkan demam pada anak secara nonfarmakologis. Kata kunci: Demam berdarah dengue, hipertermia, tepid sponge.ABSTRACT Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children.;Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children.;Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children.;Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children."