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"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)"

"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."

"Latar belakang. Penolakan tindakan pungsi lumbal cukup besar. Salah satu faktor yang berperan adalah pengetahuan, pemahaman serta persepsi pasien dan keluarga yang kurang tepat terhadap tindakan pungsi lumbal. Informed consent yang baik diharapkan dapat memperbaiki hal ini. Penelitian ini dilakukan untuk menilai kualitas informed consent pungsi lumbal. Metode penelitian. Penelitian ini dilakukan dua tahap. Tahap 1 penyusunan dan analisis kuesioner. Tahap 2 uji coba dan penilaian reliabilitas. Tahap 1 menggunakan desain uji validasi isi. Populasi adalah dokter spesialis neurologi yang memiliki pengetahuan dan pemahaman pungsi lumbal. Sampel diambil dengan cara intentional sampling. Tahap 2 menggunakan desain potong lintang. Populasinya adalah pasien/wali pasien yang telah mendapakan informed consent pungsi lumbal di IGD, bangsal/poli neurologi RSUPN Dr. Cipto Mangunkusumo  bulan Desember 2022-Januari 2023. Sampel diambil dengan cara consecutive sampling. Hasil. Kuesioner pungsi lumbal 2022 memiliki validitas isi yang baik namun tingkat pemahaman memiliki reliabilitas yang kurang baik. Sebanyak 75% tenaga medis profesional dalam memberikan informed consent pungsi lumbal. Sebanyak 28,12% penerima informasi memahami informasi yang diberikan. Sebanyak 68,8% penerima informasi puas terhadap proses informed consent. Sebanyak 25% proses informed consent pungsi lumbal berkualitas. Kesimpulan. Sebagian besar tenaga medis sudah profesional dalam melakukan informed consent pungsi lumbal meskipun belum seluruhnya penerima informasi memahami informasi yang disampaikan. Sebagian besar penerima informasi puas dengan proses informed consent pungsi lumbal. Kualitas informed consent pungsi lumbal di RSUPN Dr. Cipto Mangunkusumo masih harus ditingkatkan.

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Background: There is quite a number of rejection for lumbar puncture procedure. One of its most contributing factor is inadequate understanding of the procedure itself from the patient or family. A well prepared informed consent is aimed to mitigate this issue. This study was conducted in order to evaluate the quality of informed consent for lumbar puncture in our centre.

Methods. This study is done in 2 phases, on the 1st phase we compose and analyze the questionnaire and on the 2nd phase is to test and evaluate its reliability. Content validation test design was used on the 1st phase. Study population are neurologists who possess the understanding and competency of lumbar puncture. Samples are chosen by intentional sampling. For the 2nd phase, we used the cross-sectional design study. And the population are patients or their family who received lumbar puncture informed consent in ER unit, neurology ward or clinic at RSUPN Dr. Cipto Mangunkusumo, starting from December 2022 to January 2023. Sample was chosen by consecutive sampling.

Results. Lumbar puncture questionnaire is pretty well validated for its content, although it’s not that well defined on how much it can be understood by the patient. As much as 75% of neurologists have given professional informed consent for their patient. But only 28.12% of the patients truly understood the information they received. And 25% of all informed consent was done in a good quality.

Conclusion. Most of neurologists have done their informed consent in a professional manner, even though not all patient could understand the information quite fully. Most of the patients are satisfied with how well the informed consent was explained. The conclusion is there are still ways to improve the quality of lumbar puncture informed consent in RSUPN Dr. Cipto Mangunkusumo "

"Di Indonesia kanker payudara adalah kanker yang paling banyak ditemukan pada wanita setelah kanker rahim. Perkembangan pengobatan kanker payudara semakin pesat setelah ditemukannya reseptor hormon pada sel kanker dan penggunaan terapi hormonal seperti tamoksifen sebagai terapi adjuvan kanker payudara. Penelitian ini bertujuan untuk mengetahui protokol pengobatan kanker payudara pada pasien yang mendapatkan tamoksifen dan untuk mengetahui kerasionalan penggunaan tamoksifen. Penelitian ini dilakukan melalui metode survei yang bersifat deskriptif dan pengumpulan datanya dilakukan secara retrospektif terhadap data rekam medik pasien kanker payudara periode bulan Januari 1999 sampai dengan bulan Maret 2004. Kriteria pasien yang dipilih adalah pasien yang mendapatkan tamoksifen dan memiliki data rekam medik yang jelas tentang kanker payudara yang diderita, dosis yang diberikan, lama penggunaan dan status reseptor estrogen dan reseptor progesteron (er/pr). Hasil penelitian menunjukkan adanya ketidakrasionalan penggunaan tamoksifen jika dilihat dari dosis, lama penggunaan dan status er/pr. Ada 1,45% pasien yang mendapatkan dosis yang tidak rasional, 97,10% yang lama penggunaan tamoksifennya tidak rasional dan 98,55% pasien yang status er/prnya tidak rasional. Dari hasil ini dapat disimpulkan bahwa penggunaan tamoksifen di Perjan RS Dr. Cipto Mangunkusumo selama periode bulan Januari 1999 sampai bulan Maret 2004, tidak rasional."

"Kepuasan pasien dalam suatu rumah sakit merupakan salah satu indikator kualitas pelayanan. Apabila pelayanan yang di terima sesuai dengan harapan, maka mutu layanan yang diberikan dipersepsikan baik atau memuaskan, dan sebaliknya, jika pelayanan. yang di terima tidak sesuai harapan, maka pelayanan tersehut dipersepsikan buruk dan tidak memuaskan.Tujuan dari penelitian adalah untuk memperoleh gambaran tingkat kepuasan pasien yang di rawat di Pal. Melati dan ruang MPKP, dengan metode Serqual terhadap pelayanan rawat inap. Pengukuran tingkat kepuasan dilakukan terhadap 120 responden, 60 pasien yang di rawat di Pav. Melati dan 60 pasien yang di rawat MPKP. Penelitian ini adalah cross sectional, dengan pendekatan kuantitatif. Sedangkan variabel yang digunakan untuk mengukur mutu layanan, menggunakan lima dimensi mutu, yaitu : tangible, reliability, responsiveness, assurance, dan empathy.Hasil penelitian ini menunjukkan bahwa tingkat kepuasan pasien di ruang MPKP ternyata lebih tinggi dari pada di Pav. Melati, untuk semua dimensi (tangible, reliability, responsiveness, assurance, dan empathy). Sedangkan karakteristik responder yang berhubungan dengan tingkat kepuasan ternyata hanya pekerjaan di Pav. Melati sedang umur dan pendidikan tidak ada hubungan, baik di Pav. Melati maupun ruang MPKP. Menyarankan kepada pihak manajemen Perjan, Rumah Sakit Dr. Cipto Mangunkusumo untuk menerapkan secara optimal MPKP di seluruh ruang rawat, khususnya Paviliun Swadana (VIP), sehingga mutu pelayanan akan lebih berkualitas.

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Patient satisfaction in the hospital is one of the indicators of the quality of hospital-health care that have been given to patients, as clients.

If the hospital-healthcare received is equal to that expected by the patients, the quality health insurance would be considered good-and satisfy the patients. On the contrary, if the hospital-healthcare received is not as expected by or satisfy the patients, the healthcare will be of bad perception and disappointment.

The aim of this study is to find the description of in-patient satisfaction level at "Melati" Pavilion and the "Professional Nursing Practice Model" (PNPM) ward or "Ruang Rawat Model Praktik Keperawatan Profesional"(MPKP), using the Serqual Method towards ward-healthcare. Data used in this study was a primary data using univariate and bivariate analysis.

It is a quantitative cross sectional study, conducted to 120 respondents consisted of 60 in-patients at "Melati" pavilion and 60 in-patients at PNPM ward. The variable used to measure the quality health insurance were by the five quality dimensions: tangibility, reliability, responsiveness, assurance, and empathy.

The results of this study showed that the respondent satisfaction levels in all of the quality dimensions (tangible, reliability, responsiveness, assurance and empathy) in the PNPM ward was higher than that of "Melati" pavilion. There were no associations between the characteristics of the respondents (age and educational background) and the level of satisfaction in both types of wards, but there was relationship between job and the level of satisfaction of the respondents at "Melati" pavilion.

It is recommended that in order to increase the in-patient satisfaction, to apply the Professional Nursing Practice Model (PNPM) at all of the wards in RSCM optimally, especially the VIP pavilions, as a result the health quality insurance will be qualified.

References : 45 (1988-2003)"