Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :

Latar Belakang: Needle Stick Injury (NSI) masih menjadi masalah keselamatan kerja bagi tenaga kesehatan. Hal ini menjadi tanggung jawab kita bersama untuk dapat bekerja dalam lingkungan yang lebih aman.Tujuan penelitian ini untuk mengetahui hasil program Needle Safety Contest (NSC) dalam menurunkan angka NSI. Metode: Penelitian ini adalah evaluasi program yang menggunakan mixed methods. Kuantitatif berupa jumlah NSI yang dibandingkan empat bulan sebelum, dan sesudah kontes. Kualitatif berupa pendalaman penyebab masalah dalam Focus Group Discussion (FGD). Hasil: Terjadi penurunan 50% prevalensi NSI pada periode sesudah kontes. Dari FGD didapatkan penyebab NSI adalah recapping jarum insulin; tindakan yang kurang berhati-hati saat menjahit luka, pengambilan darah, memasang infus, dan menyuntikkan obat ke pasien; jarum yang ditemukan tidak pada tempatnya atau dalam keadaan terbuka; melakukan modifikasi jarum yang tidak sesuai kegunaannya; kurangnya SOP tindakan menjahit luka, melakukan tindakan yang tidak sesuai kewenangan klinis; kurangnya supervisi staf baru, terutama saat melakukan tindakan invasif; kurangnya pengecekan inden consumables. Kesimpulan: NSC berhasil menurunkan prevalensi NSI pada periode sesudah kontes. Faktor penyebab NSI adalah recapping jarum insulin yang banyak terjadi pada pekerja shift dan staf baru; tindakan kurang berhati-hati saat tindakan invasif; penggunaan jarum yang tidak sesuai prosedur; kurangnya SOP tindakan penjahitan luka, kurangnya pengawasan dari senior.

 

---

Background: Needle Stick Injury (NSI) is still a safety issue for all health workers. Our shared responsibility to be able to work in a safer environment. This study aims to evaluate the Needle Safety Contest (NSC) program in reducing NSI. Methods: This study is an evaluation program that used mixed methods. Quantitative data is the number of NSI compared to four months before and after the contest. Qualitative will deepen the causative problem, using Focus Group Discussion (FGD). Results: There was a 50% decrease in NSI prevalence after the contest period. From the FGD, the cause of NSI are recapping insulin needles; careless actions when suturing wounds, preparing blood sample, infusing patients, and injecting drugs into patients; misplaced needle or put needle not properly; modifying needles not suitable for the use; lack of suture care SOP; perform actions not according to clinical authority; less senior supervision, especially when doing an invasive procedure; and lack of consumables indent checking. Conclusion: NSC succeeded in reducing the NSI prevalence in the post-contest period. NSI causative factors are recapping insulin needles, usually among shift workers and new staff; careless actions when doing invasive procedures; needles that are not suitable for the use; lack of suture care SOP; needles used not ideal with the process; less senior supervision.

Abstrak :
ABSTRAK
Hipertensi sering dijumpai dalam praktek sehari-hari dan prevalensinya di Indonesia cukup tinggi 31,7 . Press needle PN pada titik PC6, MA-IC 7 dan MA_TF 1 diketahui dapat menurunkan tekanan darah, tetapi belum ada penelitian khusus terhadap penderita hipertensi esensial. Penelitian ini bertujuan mengetahui efek PN pada titik PC6, MA-IC 7 dan MA_TF 1 terhadap tekanan darah dan skor kualitas hidup dari pasien hipertensi esensial. Disain penelitian adalah uji klinis acak tersamar ganda dengan kontrol. Melibatkan 52 pasien hipertensi yang dibagi menjadi dua kelompok. Kelompok kasus mendapatkan terapi PN dikombinasi dengan obat antihipertensi dan kelompok kontrol mendapatkan terapi PN plasebo dikombinasi dengan obat antihipertensi. kemudian pada kedua kelompok dilakukan penilaian perubahan tekanan darah dan kualitas hidup SF-36 . Hasil penelitian menunjukkan terdapat penurunan tekanan darah sistolik 30 menit dan 3 hari setelah perlakuan p0,05 , peningkatan skor SF-36 komponen MH, SF, BP dan GH 3 hari setelah perlakuan p0,05 pada kelompok kasus dibandingkan kelompok kontrol. Dapat disimpulkan bahwa terapi PN dikombinasi dengan obat antihipertensi lebih efektif menurunkan tekanan darah dan meningkatkan skor kualitas hidup pada pasien hipertensi esensial dibandingkan dengan terapi PN plasebo dikombinasi dengan obat antihipertensi.

---

ABSTRACT
Hypertension is commonly seen in Daily Practice and its prevalence in Indonesia is fairly high 31.7 . Press needle PN on PC6, MA IC 7 and MA TF 1 points is known to reduce Blood Pressure, but yet there has not been any research specially for essential hypertension. This study aims to determine the press needle Effects on PC6, MA IC 7 and MA TF 1 points to Blood Pressure And Quality of Life Score of essential hypertension patients. The study design is a randomized double blind clinical trials with Control, involving 52 hypertension randomly assigned to two groups. Treatment groups get the press needle therapy combined with antihypertensive drugs and The control group who get the press needle placebo therapy combined with antihypertensive drugs. Then the two groups evaluated for Blood Pressure And Quality of Life SF 36 . The results showed a decrease in systolic blood pressure of 30 minutes and 3 days after treatment p 0.05 , improvement of the SF 36 component scores MH, SF, BP and GH 3 days after treatment p 0.05 in the treatment group compared to the control group. It can be concluded that the PN therapy in combination with antihypertensive drugs more effectively reduce blood pressure and improve the quality of life scores in patients with essential hypertension compared with placebo PN therapy in combination with antihypertensive drugs.

Abstrak :
People are capable of ingesting , inserting, or injecting themselves or others with all manner of foreign objects. Ingested or inserted foreign bodies may cause bowel obstruction or perforation: which lead to severe hemorrhage, obscess formation or septicemia ; or distant embolization....

Abstrak :
ABSTRAK
A 30-year-old Javanese-Indonesian man was admitted with complaints of 3 months persistent fever, weight loss, and fatigue. He had never known his past history of unprotected HIV until the admission. His only risk factor is unsafe sex. The patient seemed well nourished. Physical examination revealed blood pressure 100/60 mmHg, pulse 100 beats per minute, respiratory rate 20 times per minute, and temperature 38.8°C. Multiple cervical and inguinal lymphadenopathies were also found. Electrocardiogram showed anterolateral ischemic finding, whereas chest X-ray were normal. Laboratory test results revealed pancytopenia with hemoglobin of 8.2 g/dL, leucocyte count 2000 cells/mm3, platelet 78000 cells/mm3, hematocrit 25.8%, AST 162 IU/L, ALT 81 IU/L, decreased albumin of 2.72 g/dL. The clinical differential diagnosis were lymphoma or tuberculosis lymphadenopathy.

Abstrak :
ABSTRAK
BACKGROUND: The incidence lung tumors and mediastinum tumors are the main causes of death due to malignancies with 12,9% of all malignancy cases. Lung tumors are more common in developing countries. Biopsy of lung tumors and mediastinal tumors is a frequent and multidisciplinary action. The minimally invasive technique that is mostly done is percutaneus transthoracic needle aspiration biopsy (PTNAB). Research states that PTNAB is a safe, effective, and accurate procedure. OBJECTIVE: This study aimed to assess the effect of needle biopsy size on the success of biopsy and the incidence of pneumothorax in intrathoracal tumor patients in Hasan Sadikin General Hospital for the period 2014-2016. METHODS: This study is a clinical epidemiological study and observational analytic with a cross sectional study design involving 232 data of patients who met the inclusion criteria and did not meet the exclusion criteria. Matching is done because there are differences in the number of research subjects in each group. The total number of research subjects is 158 patient data. The test used is chi square. RESULTS: The results showed that PTNABs actions using large and small needles had a success rate of 73,4% and 49,4%, respectively, and were significantly different (p <0,05). The success rate of PTNABs actions is not significantly different from lung tumors and mediastinum. The success rate of PTNABs actions in mediastinal tumors using large and small needles was 92,3% and 50%, respectively, and was significantly different (p <0,05). The incidence of pneumothorax after PTNABs action is zero in both groups so analysis cannot be performed. CONCLUSION: This study concluded that the success of PTNABs actions using large-sized needles on small-sized needles differed significantly.

Abstrak :
Semua aktivitas yang dilakukan dalam memberikan pelayanan kesehatan menempatkan tenaga kesehatan pada risiko Keselamatan dan Kesehatan Kerja (K3), termasuk perawat. Salah satu kecelakaan yang dapat menimbulkan cedera, penyakit bahkan kematian akibat infeksi yang ditularkan melalui darah adalah kejadian Needle-stick and Sharp Injuries (NSSI). Kejadian NSSI dan faktor-faktor yang berhubungan di RS PMI Bogor pada perawat belum terdata dengan baik. Penelitian ini menggunakan metode cross sectional dan kuesioner sebagai instrumen dalam mengumpulkan data. Teknik pengambilan sampel pada penelitian ini menggunakan metode total sampling, yaitu seluruh perawat yang bekerja di Instalasi Rawat Inap, Instalasi Gawat Darurat dan Instalasi Bedah RS PMI Bogor dengan jumlah responden 216 Orang. Hasil penelitian menunjukkan bahwa kejadian NSSI dalam 1 tahun terakhir adalah 49,5% dengan penyebab tersering adalah terkena pecahan ampul (49,5%) dan pada saat mematahkan tutup ampul kaca (48,6%). Tidak ada hubungan yang bermakna antara masa kerja, pelatihan, unsafe acts, dan unsafe conditions dengan kejadian NSSI. Terdapat hubungan yang bermakna antara pengetahuan dengan kejadian NSSI. Untuk mencegah terjadinya NSSI maka perlu dilakukan peningkatan pengetahuan perawat, pemerataan promosi pencegahan dan penatalaksanaan kejadian NSSI serta sistem pelaporan kecelakaan kerja yang terintegrasi dan diikuti dengan surveilans. ...... All activities undertaken in providing health care put health workers at Occupational Health and Safety risk, including nurses. One of the accidents that can cause injury, illness and even death from blood-borne infections is Needle Stick and Sharp Injuries (NSSI). NSSI incidence and factor associated with NSSI at Indonesian Red Cross Hospital nurses have not been recorded properly. A cross-sectional study was conducted, using questionnaire as an instrument to collect data. The sampling technique in this study used total sampling method, which was all nurses working in Inpatient, Emergency and Surgical Installation. A total of 216 nurses were accepted for inclusion. Results showed that the incidence of NSSI in the last 1 year was 49.5%, with the most common cause was glass ampoule cap (49.5%) and the most frequently reported circumstances of NSSI was breaking the glass ampule cap (48.6%). There was no statistically significant association between experience, training, unsafe acts and unsafe conditions with NSSI. There was statistically significant association between knowledge with NSSI. To prevent the occurrence of NSSI it is necessary to increase the knowledge of nurses, promotion and integrated reporting of occupational accident, followed by surveillance.

Abstrak :
Prosedur esofagogastroduodenoskopi (EGD) dapat menimbulkan kecemasan, sehingga diperlukan intervensi untuk membuat pasien tenang dan rileks. Penelitian ini bertujuan untuk mengetahui efek akupunktur telinga terhadap kecemasan dan tekanan darah serta frekuensi denyut nadi pasien pada prosedur EGD. Penelitian acak tersamar tunggal dengan kontrol ini melibatkan 40 pasien yang dibagi menjadi kelompok perlakuan yang mendapatkan akupunktur telinga menggunakan press needle pada titik shenmen, relaksasi dan zero point. Sedangkan kelompok kedua sebagai kontrol mendapatkan press needle sham pada titik yang sama. Pengukuran kecemasan dilakukan menggunakan kuesioner Spielberger State Anxiety Inventory (SAI) yang diberikan sebelum intervensi dan 10 menit setelah endoskopi selesai. Dilakukan pencatatan tekanan darah dan frekuensi nadi sebelum intervensi, selama dan setelah EGD. Terdapat penurunan skor SAI yang bermakna pada kelompok akupunktur (p<0,001). Rerata selisih skor SAI kelompok akupunktur lebih besar dibandingkan dengan kelompok sham (p<0,001). Tidak terdapat perbedaan rerata tekanan darah dan frekuensi denyut nadi antara kedua kelompok. Akupunktur telinga menggunakan press needle pada titik shenmen, relaksasi dan zero point dapat menurunkan kecemasan pasien selama prosedur EGD. ...... Esophagogastroduodenoscopy (EGD) procedure can cause anxiety, so that the necessary interventions that can make patients relax and calm. The objective of this study was to investigate the effect of auricular acupuncture towards anxiety, blood pressure and pulse rate of patient on the oesophagogastroduodenoscopy procedure. This randomised, single blinded study with 40 patients undergoing EGD without sedation were divide into two groups acupuncture and sham acupuncture group. Patients received press needle or sham press needle at the shenmen, relaxation, and zero point. Anxiety was assessed using the Spielberger State Anxiety Inventory (SAI) before and 10 min after procedure. Blood pressure and pulse rate were monitored before intervention, during and after endoscopy using automated blood pressure monitor. Mean score of SAI were decreased after auricular acupuncture (p<0,001). Mean difference score of acupuncture group was higher than sham group (p<0.001). The mean change in systolic and diastole blood pressure and pulse rate between groups were not significant different. Auricular acupuncture with press needle on senmen, relaxation and zero point reduces anxiety during EGD procedure.

Abstrak :
Salah satu risiko keselamatan dan kesehatan perawat di Rumah sakit adalah needle stick and sharp injuries (NSSI) yang dapat menimbulkan cedera, penyakit bahkan kematian akibat infeksi yang ditularkan melalui darah atau cairan tubuh lainnya. Kejadian dan pelaporan NSSI di RSKO pada perawat belum terdata dengan baik. Penelitian ini adalah penelitian kuantitatif dan kualitatif dengan desain cross sectional, meneliti faktor-faktor yang berhubungan dengan NSSI. Pada penelitian kuantitatif, pengambilan data dilakukan pada 76 responden di Instalasi Gawat Darurat, Instalasi Rawat Inap Bidadari/HCU, Instalasi Rawat Jalan dan Rehabilitasi/Detok. Hasil penelitian menunjukan dalam 1 tahun terakhir, sebanyak 40 orang (52,6 persen) mengalami NSSI, penyebab tersering NSSI adalah pecahan vial/ampul 32,5 persen dan 32,5 persen mengalami NSSI saat mematahkan ampul/vial. Tidak ada hubungan bermakna antara faktor predisposisi dan faktor pemungkin dengan NSSI. Ada hubungan bermakna antara faktor penguat yaitu faktor punishment dengan NSSI dengan nilai p 0.042. Pada penelitian kualitatif diketahui Pelatihan merupakan faktor predisposisi/individu yang paling penting terkait NSSI, Ketersediaan APD adalah faktor pemungkin/sarana paling penting yang harus disediakan RS untuk mencegah NSSI. Adanya SOP merupakan faktor penguat yang penting untuk pencegahan NSSI. Untuk mencegah NSSI perlu pelatihan berkala, ketersediaan APD dan sosialisasi SOP. ...... One of the risks to the nurses' safety and health in the hospital is the needle stick and sharp injuries (NSSI) that can cause injury, disease and even death from blood-borne infections or other body fluids. The incident and reporting of NSSI in RSKO on the nurse has not been properly recorded. This research is quantitative and qualitative research with cross sectional design, researching factors related to NSSI. In quantitative research, data collection was done on 76 respondents in Emergency Installation, Installation Bidadari / HCU, Outpatient Installation and Rehabilitation / Detok. The results showed in the last 1 year, as many as 40 people (52.6 percent) experienced NSSI, the most common cause NSSI fraction vial / ampoule 32.5 percent and 32.5 percent experienced NSSI when break ampoules / vials. There was no significant association between predisposing factors and enabling factors with NSSI. There is significant relation between amplifier factor that is punishment factor with NSSI with p value 0.042. In qualitative research, it is known that Training is the most important predisposing factor / individual related to NSSI. The availability of PPE is the most important factor to be provided by RS to prevent NSSI. The existence of SOP is an important reinforcing factor for NSSI prevention. To prevent NSSI need to regular training and availability of PPE and socialization of SOP.

Abstrak :
ABSTRAK
Latar belakang Fine Needle Aspiration Cytology FNAC adalah teknik yang cepat murah dengan komplikasi yang minimal untuk mendiagnosis tumor tulang FNAC memiliki kapasitas untuk membedakan lesi jinak dan ganas Namun masih banyak kontroversi tentang penggunaan FNAC sebagai salah satu alat diagnostik tumor tulang seperti keterbatasan FNAC di sisi teknik dan cara interpretasi Penelitian ini bertujuan untuk mengevaluasi akurasi FNAC sebagai salah satu prosedur preoperasi diagnosis tumor tulang Metode Sampel diambil dari arsip rekam medis pasien curiga tumor tulang yang diperiksa dengan FNAC dan histopatologi di Departemen Patologi Anatomi FKUI RSCM dari tahun 2011 sampai 2014 Uji diagnostik dilakukan untuk mengetahui sensitivitas spesifisitas PPV NPV dan akurasi dari FNAC Hasil Terdapat 78 pasien kasus curiga tumor tulang yang diperiksa dengan FNAC dan Histopatologi di Departemen Patologi Anatomi FKUI RSCM pada tahun 2011 ndash 2014 Empat puluh sembilan kasus dilaporkan tumor tulang ganas dengan 5 kasus diskrepansi subtipe ganas dan 20 kasus tumor tulang jinak dengan 1 kasus diskrepansi subtype jinak Selain itu terdapat 8 kasus negatif semu dan 1 kasus positif semu Secara keseluruhan hasil yang didapatkan adalah sensitivitas 86 spesifisitas 95 2 PPV 98 NPV 71 4 dan akurasi sebesar 88 5 Kesimpulan Penelitian ini menunjukkan bahwa FNAC memiliki kualitas yang baik untuk mendiagnosis tumor tulang dibuktikan dengan tingginya angka sensitivitas dan spesifisitas 86 dan 95 2 FNAC dapat memberikan diagnosis yang akurat jika diikuti dengan pengambilan spesimen yang baik data klinis dan radiologi yang lengkap

---

ABSTRACT
Background Fine Needle Aspiration Cytology FNAC is a rapid inexpensive minimum invasive technique with less complication in diagnosing bone neoplasm FNAC is able to differentiate between neoplasm and non neoplasm cases However there are still many controversies regarding the usage of FNAC as a diagnostic approach of bone neoplasm such as the limitations of FNAC technique and interpretation This research aims to evaluate the accuracy of FNAC as one of diagnostic approach in preoperative or diagnosing bone neoplasm Method Samples were obtained from archives of medical records data of patients who clinically suspected of bone neoplasm and undergo FNAC Histopathology in Anatomical Pathology Department FKUI RSCM from 2011 to 2014 Following this the diagnostic test will be conducted in order to obtain the sensitivity specificity PPV NPV and accuracy of FNAC Results There are 78 patients of bone neoplasm were undergo Fine Needle Aspiration Cytology and Histopathology examination from the archives Anatomical Pathology Department in 2011 to 2014 Forty nine cases were reported as malignant bone neoplasm with 5 discrepancy type and 20 cases were benign with 1 discrepancy type Furthermore there were 8 false negative cases and 1 false positive case The sensitivity specificity positive predictive value PPV negative predictive value NPV accuracy were 86 95 2 98 71 4 and 88 5 respectively Conclusions FNAC shows a good quality as one of diagnostic approach in bone neoplasm as can be seen in a high sensitivity and specificity 86 and 95 2 in this study FNAC of bone neoplasm might give a highly accurate diagnosis if accompanied by a high quality of technique sampling adequate specimen clinical and radiologic assistance

Abstrak :
Pendahuluan: Salah satu efek samping kemoterapi yang paling sering terjadi dan meresahkan pada pasien anak adalah Chemotherapy induced nausea and vomiting (CINV). Akupunktur merupakan suatu pendekatan non farmakologi yang telah terbukti dapat menurunkan gejala CINV. Namun, aplikasi pada anak sering kali terkendala rasa takut akan jarum. Salah satu modalitas yang minimal invasif dan dapat diaplikasikan pada anak adalah press needle. Tujuan penelitian ini adalah untuk menilai efektivitas akupunktur press needle dalam mengurangi gejala CINV yang dinilai berdasarkan skor Rhodes index of nausea, vomiting, and retching (RINVR) pada pasien kanker anak yang menjalani kemoterapi. Metode: Desain studi ini adalah uji klinis acak terkontrol tunggal dengan kontrol sham. Penelitian ini diikuti oleh 60 pasien kanker anak yang menjalani kemoterapi. Subjek penelitian dialokasikan secara acak ke dalam kelompok perlakuan (n=30) dan kontrol (n=30). Pada kelompok perlakuan dilakukan pemasangan press needle pada titik PC6 Neiguan dan ST36 Zusanli, dilanjutkan dengan perangsangan akupresur minimal 3 kali sehari, sementara pasien pada kelompok kontrol mendapatkan press needle sham Plesterin® tanpa diikuti perangsangan apapun. Selama penelitian seluruh subjek tetap mendapatkan terapi anti emetik standar. Pemasangan press needle dilakukan sebelum kemoterapi dan dipertahankan hingga 3 hari pasca kemoterapi. Evaluasi mual muntah dilakukan setiap hari hingga 6 hari pasca kemoterapi menggunakan kuesioner Rhodes index of nausea, vomiting, and retching. Hasil: Terjadi penurunan skor RINVR yang signifikan antara hari kemoterapi dengan 3 hari pasca kemoterapi pada kelompok perlakuan ( p = 0,005 ). Skor RINVR pada hari pemberian kemoterapi, 3 hari dan 6 hari pasca kemoterapi pada kelompok perlakuan lebih rendah dibandingkan kelompok kontrol, namun perbedaan kedua kelompok tidak berbeda bermakna (p = 0,525, p = 0,506, p = 0,284). Kesimpulan: Akupunktur press needle mampu menurunkan skor RINVR pada pasien anak yang menjalani kemoterapi dan dapat diaplikasikan pada pasien anak karena efek sampingnya yang minimal, namun perlu dilakukan penelitian lebih lanjut untuk mengetahui waktu terapi yang sesuai. ......Background: Chemotherapy induced nausea and vomiting (CINV) are the most prevalent yet disturbing side effects of chemotherapy. Acupuncture is a non-pharmalogical approach that has been shown to reduce CINV symptoms. However, acupuncture in children is often constrained by a fear of acupuncture needles. Press needle is minimally invasive modalities that might be applied. The purpose of this study was to assess the effectiveness of press needle acupuncture in reducing CINV according to Rhodes index of nausea, vomiting, and retching (RINVR) score in pediatric cancer patients undergoing chemotherapy. Method: The study design was a single randomized controlled trial with sham control. A total of 60 subjects were randomly allocated into treatment ( n = 30 ) and control ( n = 30) groups. Subjects in treatment group will received press needle at PC6 Neiguan and ST36 Zusanli, followed by acupressure stimulation at least 3 times a day, while patients in the control group received press needle sham Plesterin® without any further stimulation. During the study all subjects continued to receive standart anti-emetic therapy. The insertion of the press needle was performed before chemotherapy and retained up to 3 days after chemotherapy. Nausea and vomiting was evaluated everyday up to 6 days after chemotherapy using a Rhodes index of nausea, vomiting, and retching questionnaire. Result: The RINVR score decreased significantly between the days of chemotherapy and 3 days post chemotherapy (p = 0,005) in treatment group. Comparation of RINVR score on chemotherapy days, 3 , and 6 days after chemotherapy was lower in treatment group but not significantly different between two groups ( p = 0,525, p = 0,506, p = 0,284). Conclusion: Press needle acupuncture might be effective in reducing CINV in pediatric cancer patiens and was feasible due to its minimal side effects. Further research is needed to determine the appropriate treatment time.