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Abstrak :
Background: multidrug-resistant organisms (MDRO) caused pneumonia has become a crucial case. MDRO infection has been a problem concern to community-acquired pneumonia (CAP). A lot of factors play roles in CAP with MDRO infection. This study aimed to analyze MDRO as the etiology of hospitalized patients with CAP along with its risk factors in Dr. Soetomo Hospital as one of the top referral hospitals in east Indonesia. Methods: this retrospective cohort study was conducted from January 2016 to December 2018. Data were collected from patients' medical records. Automatic Rapid Diagnosis (Phoenix TM) was used as a standard method for culture and susceptibility test. Various risk factors were analyzed for MDRO infection. Results: five most common pathogens in hospitalized patients with CAP were Acinetobacter baumannii 244/1364 (17.9%), Klebsiella pneumoniae 134/1364 (9.8%), Pseudomonas aeruginosa 91/1364 (6.7%), Escherichia coli 58/1364 (4.3%), and Enterobacter cloacae 45/1364 (3.3%). There were 294/1364 (21.5%) MDROs isolated from patients with CAP. MDRO infection was linked to previous hospitalization, malignancy, cardiovascular disease, and structural lung disease with p values of 0.002, <0.001, 0.024, and <0.001, respectively. Conclusion: the incidence of MDRO in CAP is high (21.5%). The risk factors related were previous hospitalization, malignancy, cardiovascular disease, and structural lung disease.

Abstrak :
Dari hasil residensi ternyata kemampuan supervisi beberapa kepala ruangan di ruang rawat inap RS. Pelni "Petamburan" belum optimal. Penelitian ini bertujuan mengidentifikasi karakteristik dan kemampuan supervisi kepala ruangan rawat inap dalam area personil keperawatan, area lingkungan dan peralatan, area asuhan keperawatan, area pendidikan dan pengembangan staf. Penelitian ini merupakan penelitian deskriptif analitik dengan pendekatan kualitatif dan bersifat kross seksional. Pengambilan data primer dilakukan dengan mengadakan wawancara yang mendalam dan pengisian kuesioner dan data sekunder didapat dari dokumen-dokumen yang terkait. Sampel dalam penelitian ini sebanyak 52 orang yang terdiri dari satu orang kepala divisi medis, tiga orang kepala instalasi, 12 orang kepala ruangan, 36 orang pelaksana perawatan. Dari hasil penelitian dapat disimpulkan karakteristik kepala ruangan yang dilihat dari empat sudut, yaitu usia, latar belakang pendidikan formal, masa kerja dan penataran manajemen keperawatan hanya latar belakang pendidikan formal yang sebagian besar belum memenuhi persyaratan. Sedang kemampuan supervisi dua belas orang kepala ruangan rawat inap, dari empat area tanggung jawab, ada dua area, yaitu area personil keperawatan, area lingkungan dan peralatan yang penampilannya cukup. Sedang dua area lainnya yaitu area asuhan keperawatan dan area pendidikan & pengembangan staf penampilannya baik. Saran penelitian ini: 1). Secara bertahap persyaratan sebagai kepala ruangan dari sudut pendidikan formal dipenuhi, 2) peningkatan kemampuan kepala ruangan di dua area tanggung jawab, yaitu area personil keperawatan dan area lingkungan peralatan, 3) merevisi susunan / format uraian tugas kepala ruangan yang ada saat ini dalam empat area tanggung jawab, yaitu: area personil keperawatan, area lingkungan dan peralatan, area asuhan keperawatan dan area pendidikan & pengembangan staf, 4) penelitian lebih lanjut untuk mengetahui faktor-faktor apa saja yang mempengaruhi kualitas asuhan keperawatan selain kemampuan supervisi kepala ruangan.

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The former internship conducted at Pelni " Petamburan" Hospital found that the supervision competence of ward head nurse still need to be improved. This study aimed to identify the characteristic and supervisory competence, of ward head nurse in the area of nursing personnel, environment-facility, nursing care and training and staff development. The methodology was cross sectional, using qualitative approach. Data collection was done by in-depth interview and secondary data was obtained through analyzing relevant documents. Representation from the study was 52 Staff consisted of medical division head, 3 head of installation, 12 Ward Head Nurse, and 36 nurses. The study outcome found that the characteristic of ward head nurse can be looked from four different perspective; age, formal study background, work experience and nursing management training which is just a background of formal study, in most cases is not up to standards. Thus, from 12 ward head nurse supervisory competence, from four areas of responsibility, and two more areas; nursing personnel, environment and facility performance is average. Next, the two more area nursing care, study and staff development performance was good. Feedback taken from this study is: 1) Step by step the qualification as a ward head nurse from formal study background to be complete. 2) Development in ward head nurse in two responsibility area ; nursing personnel and environment facility area. 3) Reformat the job description of ward head nurse. 4) The continue study for knowing what factors which influence the quality of nursing care beside the supervisory competence of ward head nurse.