Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 18 dokumen yang sesuai dengan query
cover
Fransisca Mayer
Abstrak :
[Rumah sakit sebagai sarana pelayanan kesehatan yang terpadu harus mempunyai semua ukuran yang dapat menjamin peningkatan mutu. Instalasi Gawat Darurat (IGD) merupakan gerbang awal rumah sakit yang perlu dilakukan penilaian mutu pelayanan kesehatan sehingga dapat mengurangi terjadinya komplain dan meningkatkan derajat kesehatan pasien. Tujuan dari penelitian ini adalah untuk memperoleh gambaran pelaksanaan Standar Pelayanan Minimal (SPM) RS di IGD RS Sentra Medika Cibinong. Jenis penelitian yang digunakan bersifat kuantitatif dan kualitatif (mix method research) untuk memperoleh pemahaman yang baik. Hasil penelitian menyarankan agar pihak manajemen perlu membuat atau melengkapi kebijakan/ SPO terutama untuk hal yang berkaitan dengan pelayanan di IGD, termasuk dalam pengelolaan SDM untuk mengantisipasi jam pelayanan sibuk, membuat rencana diklat/ pelatihan, melengkapi sarana dan prasarana, serta membentuk tim penanggulangan bencana di IGD.;Hospital as an integrated health care facilities must have all the sizes that can guarantee its quality improvement. Emergency department as a starting gate hospitals need to do quality assessment of health services to reduce the occurrence of complaints and improve the health’s degree of the patients. The purpose of this research is to obtain the implementation of minimum services standard of the Sentra Medika Cibinong Hospital. Empirically types used are quantitative and qualitative study (mixed method research) to obtain a good understanding. Results of this research suggest to management needs to make the policy/ Standard Operating Procedures, especially for matters relating to the emergency services, included in the management of human resources in anticipation of the busy hour of service, create a training plan, completing the infrastructure, and build a disaster response team, Hospital as an integrated health care facilities must have all the sizes that can guarantee its quality improvement. Emergency department as a starting gate hospitals need to do quality assessment of health services to reduce the occurrence of complaints and improve the health’s degree of the patients. The purpose of this research is to obtain the implementation of minimum services standard of the Sentra Medika Cibinong Hospital. Empirically types used are quantitative and qualitative study (mixed method research) to obtain a good understanding. Results of this research suggest to management needs to make the policy/ Standard Operating Procedures, especially for matters relating to the emergency services, included in the management of human resources in anticipation of the busy hour of service, create a training plan, completing the infrastructure, and build a disaster response team]
Universitas Indonesia, 2015
T43492
UI - Tesis Membership  Universitas Indonesia Library
cover
Czeresna H. Soejono
Abstrak :
Background: polypharmacy is a major concern for elderly patients, as it links to high morbidity related to drug interaction and adverse drug effects. Not much is known about profile of polypharmacy among elderly subjects visiting emergency department (ED) for acute conditions. Methods: a cross sectional study conducted between July to December 2018 in ED of Cipto Mangunkusumo Hospital Jakarta Indonesia. All elderly patients admitted to ED were included. We evaluated drug use pattern using ATC system along with the association between polypharmacy with sex, age and number of comorbidities. Results: 475 geriatric patients visited EU 247 subjects were male (54.8%; mean age 67.69 (SD 6.58) years old). Polypharmacy was found in 57.6% subjects. The most frequently used of drug was that of alimentary tract and metabolism pharmacologic group, followed by drugs related to blood and blood forming organs, cardiovascular system, and anti-infectives for systemic use. Sex and age were not associated with polypharmacy, while more than 3 comorbidities was associated with polypharmacy. Conclusion: polypharmacy is prevalent among elderly visiting ED in Indonesia, requiring special attention from clinician to evaluate each drug and interaction among the drugs used.
Jakarta: University of Indonesia. Faculty of Medicin, 2021
610 UI-IJIM 53:1 (2021)
Artikel Jurnal  Universitas Indonesia Library
cover
Dewi Sri
Abstrak :
Rumah Sakit Atma Jaya tidak mempunyai suatu bentuk penilaian kinerja yang komprehensif dan data Rumah Sakit Atma Jaya menunjukkan bahwa 75% pasien Inslalasi Rawat Inap berasal dari Instalasi Gawat Darurat, untuk menjadikan Instalasi Gawat Darurat sebagai andalan Rumah Sakit Atma Jaya maka Instalasi Gawat Darurat Rumah Sakit Atma Jaya perlu dievaluasi kinerjanya yang selanjutnya menjadi bahan masukan bagi Rumah Sakit Atma Jaya dengan memakai pendekatan balance scorecard maka kinerja Instalasi Gawat Darurat dapat dievaluasi dari komitmen dan kepuasan kerja sumber daya manusia di Instalasi Gawat Darurat, pelayanan pasien di Instalasi Gawat Darurat, kepuasan pasien di Instalasi Gawat Darurat dan kinerja keuangan Instalasi Gawat Darurat. Penelititan ini dilakukan secara deskriptif kualitatif dan kuantitatif dengan responden sebanyak 23 orang sumber daya manusia di Instalasi Gawat Darurat, 288 orang pasien yang datang berobat di Instalasi Gawat Darurat selama bulan Mel tahun 2002 yang dipilih secara random. Alat penelititan yang digunakan yaitu : wawancara mendalam, kuesioner, dan check list. Data yang dikumpulkan dianalisa secara deskriptif kualitatif dan kuantitatif. Hasil penelitian menunjukkan bahwa indikator sumber daya manusia di Instalasi Gawat Darurat belum baik yaitu mereka tidak puas dan tidak komitmen terhadap Instalasi Gawat Darurat. Akibat dari indikator sumber daya manusia yang belum baik tersebut mempengaruhi proses pelayanan pasien di Instalasi Gawat Darurat. Indikator proses pelayanan yang belum baik tersebut mempengaruhi proses kepuasan pasien Instalasi Gawat Darurat terutama terhadap waktu tunggu rawat dan pelayanan dokter. Pasien yang tidak puas terhadap pelayanan yang diterima di Instalasi Gawat Darurat memberi dampak kurang baik terhadap pemasukan keuangan Instalasi Gawat Darurat ke rumah sakit sehingga rumah sakit tidak mampu memberi subsidi sebesar yang diharapkan sumber daya manusia di Instalasi Gawat Darurat. Hendaknya Direktur Rumah Sakit Atma Jaya menggunakan hasil penelitian ini sebagai dasar penilaian kinerja selanjutnya dan meninjau ulang kebijakan yang ada untuk meningkatkan kinerja di rumah sakit.
Performance Evaluation of Emergency Department at Atma Jaya Hospital in May 2002 Atma Jaya hospital doesn't have the comprehensive performance evaluation. There are 75% patients of in patient department come from emergency department, therefore emergency department need to become Atma Jaya hospital priority for performance evaluation then it will become an input in Atma Jaya hospital strategic planning. By using balanced scorecard approach, the performance of emergency department can be evaluated through its commitment and the work satisfaction of human resource in the emergency department, the process of patient service in the emergency department, the satisfaction of the emergency department?s patient, and the performance of the financial of the emergency department. This research was carried out by qualitative and quantitative descriptive, by using 23 respondents? human resources of emergency department, 288 patients who came to be cared in the emergency department during May 2002. The research was done by in depth interview, questioner, and checklist. The collected data were analyzed by qualitative and quantitative descriptive. The result of the research shows that human resource indicator in emergency department is not so good i.e. they are not satisfied and they do not commit to emergency department. The effect of that not so good human resource indicator influences the patient?s service process to the patient in emergency department. That not so good service process indicator influences the satisfaction of the emergency department's patient. The unsatisfaction of emergency department's patients especially about waiting time of care and the doctor's services. The unsatisfied patients to the service in emergency department causes not so good effects to the emergency department's earning to the hospital, so the hospital can not give subsidy as much as subsidy hoped by the human resource of emergency department. Atma Jaya Hospital can uses this research to be hospital foundation for next becoming performance evaluation, and Board of Director must observe at a distance about Atma Jaya Hospital policy that uses to raise performance of emergency department.
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2000
T7855
UI - Tesis Membership  Universitas Indonesia Library
cover
Elmi Wirni
Abstrak :
Tujuan penelitian ini adalah untuk mendapatkan gambaran tentang kontribusi antara penampilan upaya pelayanan gawat darurat terhadap kepuasan pasien. Jenis penelitian ini adalah analitik kuantitatif dengan pendekatan cross sectional. Populasi penelitian ini adalah pasien ruangan gawat darurat yang diijinkan oleh perawat dan dokter yang bertanggung jawab, dengan jumlah berdasarkan rumus yakni berjumlah 100 responden. Data primer dikumpulkan menggunakan kuesioner skala Likert dengan hasil uji reliabilitas 0, 8700 untuk pelayanan dan 0,8956 untuk kepuasan menggunakan uji Cronbach alpha. Analisis data dilakukan secara univariat, bivariat, multivariat. Analisis univariat adalah untuk mengetahui distribusi frekuensi pelayanan gawat darurat dan kepuasan pasien terhadap pelayanan tersebut, sedangkan bivariat tujuannya adalah untuk mengetahui kontribusi penampilan upaya pelayanan gawat darurat (pelayanan medis, keperawatan, administrasi, sarana dan pra-pelayanan gawat darurat) terhadap kepuasan pasien. Analisis multivariat ditujukan untuk mengetahui pelayanan yang paling berkontribusi dengan kepuasan pasien. Penelitian menunjukkan lebih banyak pasien laki-laki dari pada perempuan, umur muda lebih banyak dari pada tua, pendidikan tinggi lebih banyak dari pendidikan rendah dan lebih banyak bekerja dari pada tidak bekerja. Rata-rata skor penampilan upaya untuk pelayanan media, keperawatan, administrasi keuangan, fasilitas, dan pra-pelayanan gawat darurat, secara berurut adalah 3.90, 3.77, 3.62, 3.79, dan 3.66. Skor rata rata kepuasan pasien terhadap pelayanan media, keperawatan, administrasi keuangan, fasilitas dan pra-pelayanan gawat darurat, secara berurutan adalah 2.95, 2.86, 2.72, 2.85, dan 2.76. Total rata-rata dari kepuasan pasien adalah 2.83 dengan SD 0.34. Hasil analisis bivariat dengan uji chi square adalah adanya kontribusi bermakna dari kelima penampilan upaya pelayanan gawat darurat terhadap kepuasan umum pasien dengan p-value <0,05. Sedangkan hasil analisis multivariat dengan uji multiple regretion dapat menunjukkan penampilan upaya pelayanan gawat darurat yang paling berpengaruh pada kepuasan pasien, yakni penampilan upaya pra-pelayanan gawat darurat dengan nilai beta 0,382 dan nilai p = 0,0001. Kesimpulan dari penelitian ini adalah hanya sebagian pasien yang merasakan puas terhadap penampilan upaya pelayanan gawat darurat. Penampilan upaya pelayanan gawat darurat, secara bermakna berkontribusi terhadap kepuasan umum pasien khususnya adalah upaya penampilan pra-pelayanan gawat darurat. Ketidakpuasan pasien terbesar adalah pada pra-pelayanan gawat darurat dan pelayanan administrasi keuangan.Oleh karena itu saran yang diutamakan adalah perlunya peningkatan pada pra-pelayanan dan administrasi keuangan. Peningkatan yang disarankan adalah dilengkapinya tenaga pemandu dan alat yang dibutuhkan pemandu, demikian juga pelatihan menghadapi pasien dan keluarganya sebagai mitra, bagi tenaga administrasi keuangan.
Contribution Analysis for Service Performance of Emergency Department and Patient Satisfaction in Emergency Department of Dr. Ciptomangunkusumo, JakartaThe purpose of this research study was to analyze the contribution of emergency services towards patient satisfaction. This study used the descriptive analytic with quantitative research method and cross sectional. The research population was the patients treated in emergency unit permitted by the nurse and physician in charge, and the total samples were 100 respondents. The primary data was collected using Likert scale questionnaire with tested reliability of 0.8700 for service and 0.8956 for satisfaction using Cronbach alpha. Data was analyzed utilizing univariate, bivariate and multivariate statistical treatments. Univariate analysis used to find out frequency distribution of emergency services and patient satisfaction on its service. Analysis bivariate was used to identify the contribution of emergency services (medical, nursing, administration, facility, and pre-emergency services) towards patient satisfaction. Multivariate analysis was aimed to identify the most determinant factor contributed to patient satisfaction. The research study revealed that more male than female patients, more younger and more educated as well as more working patients characteristics as respondents. The average (mean) scores of medical, nursing, administrative, facility and pre-emergency services - subsequently were 3.90, 177, 3.62, 3.79, and 3,66. The mean scores of patient satisfaction towards medical, nursing, administrative, facility, and pre-emergency services, subsequently were 2.95, 2.86, 2.72, 2.85, and 2.76. The total average of patient satisfaction was 2.83 and SD of 0.34 The result of bivariate analysis result using Chi Square was the significant contribution of the whole five emergency services towards patient satisfaction with p-value of < 0.05. While, multivariate analysis and multiple regression proved the most determinant emergency service contributed to patient satisfaction was the pre-emergency service with the Beta value = 0.382 and p = 0.0001. The conclusions of this study that only half of the respondent were satisfied with the emergency services and that services has a significant contribution to patient satisfaction in general, particularly pre-emergency service. The patient most dissatisfaction is on the pre-emergency service and financial administrative service. The recommendations are the improvement of pre-emergency service and financial administration, as well as training for the employees responsible for pre-emergency services.
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2002
T 10122
UI - Tesis Membership  Universitas Indonesia Library
cover
Kms Anhar
Abstrak :
[Instalasi gawat darurat (IGD) rumah sakit adalah bagian dari rumah sakit yang memberikan layanan terdepan. Di Rumah Sakit dr. Mohammad Hoesin (RSMH) Palembang sudah terdapat IGD berdasarkan SK Direktur Utama Rumah Sakit yang menetapkan struktur organisasi, tugas dan tanggung jawab, visi dan misi, dan prosedur tetap pelayanan gawat darurat. IGD RSMH Palembang dikepalai oleh seorang dokter spesialis bedah urologi dibantu oleh dua orang kepala ruangan. Standar pelayanan di IGD sudah menerapkan standar layanan sesuai dengan standar akreditasi KARS 2012. IGD keberadaannya di rumah sakit diatur oleh Kepmenkes RI No. 856/Menkes/SK/IX/2009 tentang Standar IGD. Kepemenkes ini mengatur tentang standarisasi pelayanan gawat darurat di rumah sakit, dalam Kepmenkes tersebut diatur standar organisasi, sumber daya manusia, pelayanan, kelengkapan sarana prasarana di IGD. Di RSMH Palembang telah dilaksanakan dokter spesialis jaga on site di IGD sejak 30 Januari 2014 sebagai tindak lanjut Kepmenkes RI tersebut. Sejak dilaksanakan kebijakan dokter spesialis jaga on site di IGD masih dijumpai kepatuhan para dokter masih belum optimal dan walaupun mutu layananan semakin membaik sejalan dengan telah terakreditasi paripurna rumah sakit versi KARS 2012. Penelitian ini bertujuan untuk mengetahui bagaimana implementasi kebijakan dokter spesialis jaga on site di IGD sudah dilaksanakan sesuai dengan tujuan yang diharapkan sesuai dengan Kepmenkes. Penelitian dilakukan dengan metode kualitatif melalui wawancara mendalam pada informan. Informan yang diwawancarai adalah jajaran Direktur RSMH Palembang, Ketua Komite Medik, Kabag. Keuangan, Kepala ruangan IGD dan para dokter spesialis. Penilaian hasil wawancara menggunakan kerangka fikir model implementasi kebijakan George Edward III dengan variabel sumber daya, komunikasi, disposisi dan struktur organisasi. Dari hasil penelitian ini didapatkan implementasi kebijakan dokter spesialis jaga on site belum berjalan dengan baik, disebabkan karena faktor komunikasi, disposisi dan struktur organisasi belum berjalan baik dan masih banyak perlu dukungan sumber daya. Usulan yang diberikan adalah penambahan dan kompetensi tenaga sesuai standar, revisi SOP, penyediaan media komunikasi, perbaikan fasilitas, meningkatkan koordinasi dan fungsi pengawasan secara berkala, advokasi ke Kemenkes RI.;Emergency department (ED) is a part of hospital which giving advanced services. In dr. Mohammad Hoesin (RSMH) Palembang hospital already own an emergency department based on SK director of the hospital whom establishes the organizational structure, duties and responsibilities, vision and mission, and standard operating procedures emergency services. ED RSMH Palembang is lead by a specialist urology and assisted by two heads of the room. Standard service of ED has implementing service standards according to accreditation standards KARS 2012. ED in the hospital arranged Indonesian health minister No. 865/Menkes/SK/IX/2009 about ED standards. The head of health minister regulates the standardization of emergency services at the hospital, which managing standard organizations, human resources, services, completeness infrastructure in ED. RSMH Palembang has been implemented specialist doctors duty on site in the ER since January, 30th 2014 as a follow-up of the head of the Indonesian health minister. Ever since implemented a policy specialist on duty in the ER site still found the compliance of the doctors are still not optimal and although the quality of service has improved in line with acreditation hospital KARS version 2012. This research aims to determine how the implementation of policy specialists doctors on site in the ER has been implemented in accordance with the expected goals in accordance with the head of health minister. Research done with qualitative method by performing in-depth interviews on informants. Informants interviewed are RSMH Palembang board of directors, chairman of the medical committee, chief financial officer, head of the ED room and specialist doctors. Assessment interview results are using logical framework policy implementation model George Edward III with variable resources, communications, disposition and organizational structure. From the results of this study, the implementation of policy specialist doctors on site guard has not run well, due to the communication factor, disposition and organizational structure has not been going well and much needed resource support. The given proposal is the addition of appropriate power and competence standards, the revised SOP, provision of communication media, improvement of facilities, improving the coordination and monitoring functions regularly, advocacy to the head of the Indonesian health minister, Emergency department (ED) is a part of hospital which giving advanced services. In dr. Mohammad Hoesin (RSMH) Palembang hospital already own an emergency department based on SK director of the hospital whom establishes the organizational structure, duties and responsibilities, vision and mission, and standard operating procedures emergency services. ED RSMH Palembang is lead by a specialist urology and assisted by two heads of the room. Standard service of ED has implementing service standards according to accreditation standards KARS 2012. ED in the hospital arranged Indonesian health minister No. 865/Menkes/SK/IX/2009 about ED standards. The head of health minister regulates the standardization of emergency services at the hospital, which managing standard organizations, human resources, services, completeness infrastructure in ED. RSMH Palembang has been implemented specialist doctors duty on site in the ER since January, 30th 2014 as a follow-up of the head of the Indonesian health minister. Ever since implemented a policy specialist on duty in the ER site still found the compliance of the doctors are still not optimal and although the quality of service has improved in line with acreditation hospital KARS version 2012. This research aims to determine how the implementation of policy specialists doctors on site in the ER has been implemented in accordance with the expected goals in accordance with the head of health minister. Research done with qualitative method by performing in-depth interviews on informants. Informants interviewed are RSMH Palembang board of directors, chairman of the medical committee, chief financial officer, head of the ED room and specialist doctors. Assessment interview results are using logical framework policy implementation model George Edward III with variable resources, communications, disposition and organizational structure. From the results of this study, the implementation of policy specialist doctors on site guard has not run well, due to the communication factor, disposition and organizational structure has not been going well and much needed resource support. The given proposal is the addition of appropriate power and competence standards, the revised SOP, provision of communication media, improvement of facilities, improving the coordination and monitoring functions regularly, advocacy to the head of the Indonesian health minister]
Universitas Indonesia, 2015
T44220
UI - Tesis Membership  Universitas Indonesia Library
cover
Gustiane Adriani Dwisari
Abstrak :
Pelayanan di Instalasi Gawat Darurat (IGD) memegang peran penting dalam menentukan kualitas pelayanan dan keselamatan pasien di rumah sakit. Indikator kinerja IGD, seperti Length of Stay (LOS), yang mengukur lama pasien d IGD dari kedatangan hingga pemulangan atau pemindahan, dapat memengaruhi tingkat kepadatan di IGD. Penelitian ini bertujuan untuk mengidentifikasi alur pelayanan, hambatan, dan akar penyebab masalah terkait LOS di IGD. Pengumpulan data dilakukan pada bulan April-Mei 2024 dengan pendekatan kualitatif studi kasus, berupa observasi pada 30 pasien, wawancara, dan telaah dokumen. Analisis data menggunakan flowchart untuk mengidentifikasi alur pelayanan, Value Stream Mapping untuk mengenali kegiatan bernilai dan menemukan waste, serta The Five Whys untuk menganalisis akar penyebab hambatan. Metode Lean Thinking digunakan untuk menghasilkan alur dan Model BAS (Baseline, Assess, Suggest Solution) dari Model BASICS. Hasil penelitian menunjukkan bahwa alur pelayanan pasien IGD melibatkan lima tahapan; dengan 65,5% waktu pelayanan adalah kegiatan non-value added, 23,4% kegiatan necessary but non-value added, dan 11,1% kegiatan value added, dengan total Lead Time 7 jam 55 menit 29 detik. Dari sisi pasien, waste yang terjadi meliputi waste of waiting (94,9%) dan transportation (5,1%). Bottleneck terjadi pada aktivitas menunggu terdaftar di rawat inap (25,2%), menunggu advis DPJP (22,9%), menunggu hasil pemeriksaan penunjang (22,3%), dan menunggu kesiapan rawat inap (18,2%), dengan total 88,6%. Perbaikan LOS di IGD dapat menggunakan lean tools seperti standardized work, visual management, heijunka, kaizen, dan just in time agar waste dapat dikurangi. ......Emergency Department (ED) services play a crucial role in determining the quality of care and patient safety in hospitals. Performance indicators in the ED, such as Length of Stay (LOS) which measures the duration from a patient's arrival to their discharge or transfer can significantly impact the congestion levels in the ED. This study aims to identify the service flow, obstacles, and root causes of issues related to LOS in the ED. Data collection was conducted from April to May 2024 using a qualitative case study approach, including observations of 30 patients, interviews, and document reviews. Data analysis involved using flowcharts to identify the service flow, Value Stream Mapping to recognize value-added activities and identify waste, and The Five Whys to analyze the root causes of obstacles. Lean Thinking methodology was applied to develop a service flow and the BAS (Baseline, Assess, Suggest Solution) model from the BASICS model. The study results show that the patient service flow in the ED involves five stages, with 65.5% of service time consisting of non-value-added activities, 23.4% of necessary but non-value-added activities, and 11.1% of value-added activities, resulting in a total lead time of 7 hours, 55 minutes, and 29 seconds. From the patient's perspective, the waste observed includes waiting (94.9%) and transportation (5.1%). Bottlenecks were identified in activities such as waiting to be registered for inpatient care (25.2%), waiting for specialist advice (22.9%), waiting for the results of supporting examinations (22.3%), and waiting for inpatient readiness (18.2%), totaling 88.6%. Improving LOS in the ED can utilize lean tools such as standardized work, visual management, heijunka, kaizen, and just-in-time to reduce waste.
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2024
S-pdf
UI - Skripsi Membership  Universitas Indonesia Library
cover
Siti Kusnul Khotimah
Abstrak :
Anak dengan kondisi penyakit pneumonia yang mengalami gangguan pernapasan jika tidak cepat di tangani dapat menyebabkan kematian atau kecacatan. Pemberian oksigen dan bersihan jalan napas merupakan salah cara yang efektif dan aman untuk mengurangi komplikasi. Tujuan studi kasus ini adalah memberikan gambaran asuhan keperawatan berdasarkan Teori model Konservasi Levine pada anak yang mengalami kecemasan dengan masalah respirasi di ruang gawat darurat. Model Konservasi Levine digambarkan pada 5 kasus pasien anak. Pengkajian di lakukan berdasarkan 4 prinsip yaitu Konservasi individu meliputi konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Trophicognosis, hipotesis dan intervensi dilakukan untuk mencapai adaptasi serta membuat pasien mencapai keutuhan dalam menjalani proses keperawatan di ruang gawat darurat. Model Konservasi Levine di rekomendasikan dalam memberikan asuhan keperawatan pada anak dengan masalah pneumonia. Aplikasi Evidence-Based Nursing Practice (EBNP) menggunakan desain quasi experimental pre-post test in one group dengan melibatkan 68 anak di UGD salah satu rumah sakit rujukan nasional menunjukan bahwa terapi bermain denan mewarnai gambar efektif menurunkan kecemasan anak.
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2023
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Samuel Juanputra
Abstrak :
Latar Belakang: Salah satu bidang kedokteran adalah kedokteran darurat atau emergency medicine. Bidang kedokteran ini memiliki fokus penanganan pasien pada keadaan darurat. Salah satu kedokteran darurat menangani bagian saraf pasien atau sering disebut sebagai neuroemergensi. Pada kasus neuroemergensi, dibutuhkan penilaian awal untuk menentukan prognosis pasien dan prioritas penanganan yang diperlukan. Namun, sistem-sistem yang ada sering tidak bisa dilakukan karena kurangnya sumber daya sehingga membuat sistem-sistem tersebut kurang efektif. Riset ini akan melihat hubungan tanda vital dengan prognosis pasien neuroemergensi. Alasan tanda vital digunakan adalah karena tanda vital mudah diukur dengan sumber daya terbatas. Selain itu, riset ini juga akan melihat apakah tanda vital yang selama ini digunakan secara luas untuk penilaian awal segala kasus darurat relevan untuk kasus darurat dengan penyakit saraf sebagai penyebab yang spesifik. Tujuan: Tujuan utama riset ini adalah mencari alternatif yang lebih mudah terhadap parameter yang sudah standard dalam keadaan neuroemergensi. Metode: Pasien dengan tanda vital berupa denyut nadi, laju respirasi, temperatur, saturasi oksigen, dan tekanan darah sistolik dan diastolik variabel independen dikategorikan sebagai normal dan abnormal. Lalu, hasilnya dibandingkan dengan status discharge pasien dari unit gawat darurat RSCM berupa dilepas langsung ke rumah, masuk bangsal umum, mendapat perawatan intensif, meninggal, atau dirujuk ke spesialis lain sebagai variabel dependen. Jumlah pasien pada kategori tertentu lalu dianalisis asosiasi nya. Selain itu, nilai New Early Warning Score (NEWS) juga diasosiasikan ke discharge status untuk mengecek apakah sistem ini bisa dipakai di kasus neuroemergensi. Hasil: Denyut nadi, laju respirasi, MAP, saturasi oksigen, temperature, dan skor GCS mempengaruhi status discharge pasien neuroemergensir yang juga mewakili prognosis pasien dengan nilai signifikansi masing-masing p<0,05. Kesimpulan: Penilaian awal respiratory rate, heart rate, tekanan darah diastolik dan sistolik, temperatur, saturasi oksigen, dan skor GCS bisa digunakan untuk memprediksi prognosis pasien neuroemergensi.  Tanda vital yang lebih baik berarti prognosis yang lebih baik bagi pasien neuroemergensi. Nilai NEWS juga ditemukan memiliki asosiasi signifikan pada kasus neuroemergensi.
Background: One of the fields of medicine is emergency medicine. This medicine focuses on patients' management during emergency setting. One of the available emergency medicine is neuroemergeny, which is emergency treatment with neurological diseases as the main cause. In neuroemergency cases, early assessment is required to predict patient's prognosis and determine patient's treatment priority. However, existing systems often cannot be done due to lack of resources. This research will check the association of vital signs and neuroemergency patient prognosis. Vital signs measurement is used vital signs can be measured with limited resources. Also, this research will also check whether vital signs which have been used to date for emergency assessment is relevant for neuroemergency cases specifically. Objective: To find easier alternatives to standardized parameters in determining prognosis in neuroemergency setting. Method: Vital signs of patients such as heart rate, respiratory rate, GCS score, oxygen saturation, systolic and diastolic blood pressure in the form of mean arterial pressure (MAP), and temperature as independent variable were categorized as normal or abnormal. Then the result was associated with patient discharge status from the emergency unit in RSCM such as direct-discharged home, general ward, intensive care, deceased, or referred to other specialist(s) as a dependent variable. After that, National Early Warning Score (NEWS) score associated with discharge status was also checked to know whether this system could be used to assess neuroemergency cases. Result: Heart rate, respiratory rate, MAP, oxygen saturation, GCS score, and temperature affect neuroemergency discharge status which represents patients prognosis with significance p<0.05. Conclusion: Initial assessment of heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, body temperature, oxygen saturation, and GCS score can be used to predict patient's prognosis in neuroemergency cases. Better vital signs indicate better prognosis in neuroemergency cases. NEWS score is also associated well with discharge status.
Depok: Fakultas Kedokteran Universitas Indonesia, 2017
S-pdf
UI - Skripsi Membership  Universitas Indonesia Library
cover
Liman Harijono
Abstrak :
Penelitian ini dilatar belakangi ketidakpuasan penulis terhadap survei kepuasan pelanggan di Instalasi Gawat Darurat RS Sumber Waras yang dilakukan oleh PKMPRS (Panitia Kendali Mutu Pelayanan Rumah Sakit) Sumber Waras, dimana hasil survei yang didapatkan terlalu bersifat umum, tidak memenuhi kaidah-kaidah penelitian, sukar dinterpretasikan, dan sukar dilakukan intervensi. Tujuan penelitian ini adalah mengukur persepsi pasien dan tingkat kepuasan pasien/keluarganya terhadap pelayanan di Instalasi Gawat Darurat RS Sumber Waras, mengetahui faktor-faktor yang mempengaruhi kepuasan dalam upaya untuk memperbaiki mutu pelayanan dan menyusun instrumen penelitian. Jenis penelitian yang dilakukan adalah survei dengan menggunakan pendekatan deskriptif kualitatif. Data dan informasi didapat melalui kuesioner yang diedarkan pada bulan Juli 2003 sebanyak 400 sampel. Terhadap instrumen penelitian dilakukan dua macam uji sebelum sebelum dipergunakan sebagai instrumen penelitian, yaitu : penilaian oleh kelompok Panelis dan uji coba kuesioner untuk melihat validitas dan reliabilitasnya. Dalam uji coba di Instalasi Gawat Darurat RS Persahabatan dan RS Sumber Waras, kuesioner yang dipakai menunjukkan validitas dan reliabilitas yang tinggi. Lebih lanjut dilakukan analisis univariat untuk mengetahui karakteristik personal responden, analisis bivariat untuk mencari ada tidaknya korelasi antara karakteristik personal responden dengan 5 dimensi servqual. Sedangkan analisis multivariat dipergunakan untuk mencari keeratan hubungan antara variabel dependen (karakteristik personal responden) dan 5 dimensi servqual. Dari analisis kepentingan dan kinerja/performance didapatkan bahwa 88% responden merasakan kepuasan atas pelayanan di Instalasi Gawat Darurat. Disini yang diukur adalah tingkat kesesuaiannya. Untuk menentukan prioritas yang harus dibenahi dalam upaya peningkatan mutu pelayanan, data yang ada tersebut dimasukkan ke dalam diagram Kartesius. Pada penelitian ini faktor-faktor kepuasan ditinjau dari karakteristik responden dan 5 dimensi mutu, yaitu : dimensi tangible, reliability, responsiveness, assurance dan empathy. Pada akhir penelitian diharapkan diperoleh upaya-upaya yang dapat dipergunakan untuk perbaikan.
This study has a background unsatisfactory surveys that have been done by PKMPRS (Committee on Hospital Quality Control Service) of Sumber Waras Hospital, that did not take notice of research requirements. The conclusion as the results of the surveys that have been held by PKMPRS were general. The results were difficult in interpretations and interventions. This survey attempts to measure patient satisfaction and the level of satisfaction for Emergency Departments of Sumber Waras Hospital, analyze several factors that could influence satisfaction in the efforts to improve service quality. This research is a survey that use qualitative approach. Data collected through questionnairre during July 2003. 400 questionnairres have been taken for this survey after passing the judging group assessments. The questionnairres have been tried out for validity and reliability at 2 emergency departments of Persahabatan and Sumber Waras Hospital. The results of validity and reliability have been known that the instrument has strong validity and reliability. Analysis have been done for univariate, bivariate and multivariate. Several factors influencing patient satisfaction observed with personal characteristics and 5 service quality, i.e.: tangible, reliability, responsiveness, assurance and empathy. Univariate analysis have been done for personal characteristic of the respondents and items in 5 service quality demention. Bivariate analysis used to find correlation beetwen personal characteristic of the respondents and items in 5 service quality. Importance and performance analysis have showed that 88% of the respondents have been satisfied in approving Emergency Department of Sumber Wares Hospital services. To gain the priority way out that could improve service quality have been used Cartesius diagram. There were this thesis purposes the way customer satisfaction and efforts that could make an improvement of Emergency Department of Sumber Waras Hospital.
Depok: Universitas Indonesia, 2003
T11231
UI - Tesis Membership  Universitas Indonesia Library
cover
Lilian R. Andries
Abstrak :
ABSTRAK Dalam dekade ini, insidens cedera yang termasuk kelompok penyakit tidak menular, terjadi peningkatan dan dinamakan Epidemi Baru. Di Negara Barat terkenal dengan "penyakit kelalaian masyarakat modern". Data dari. Amerika maupun Indonesia, menunjukkan cedera merupakan penyebab kematian no-4, terutama pada usia muda dan diharapkan sebagai generasi penerus menjadi sumber daya manusia yang produktif. Selain mortalitas, cedera menyebabkan morbiditas seperti kecacatan dan ketidak-mampuan. Tujuan penelitian untuk mengetahui pengaruh faktor keparahan cedera anatomic terhadap kematian kasus cedera di IGD RSUPN CM Jakarta. hasil penelitian diharapkan memberikan sumbangan pemikiran bagi pengelola program dan para pengambil keputusan, disamping sebagai masukkan dunia ilmu pengetahuan di Indonesia. Disain penelitian ini adalah Kasus Kontrol. Kasus Penelitian adalah kasus cedera yang dirawat di IGD atau mati sesudah dirawat nginap dalam waktu >7 hari dari saat masuk IGD RSUPN CSI. Kontrol Penelitian adalah kasus cedera yang hidup >7 hari dari saat masuk IGD RSUPN CM. Jumlah kasus 216 dengan kontrcl 221. Penelitian ini tidak melakukan matching. OR (Odds Ratio) kematian diperhitungkan dengan analisis regresi logistik multivariat. Faktor yang diteliti adalah:l) Karakteristik Manusia (umur dan Jenis kelamin); 2) Karakteristik Cedera (nilai keparahan cedera anatomis nilai keparahan cedera fisiologis dan mekanisme cedera) serta 3) Manajemen Cedera (rujukan dari Rumah Sakit lain, angkutan kasus ke IGD, waktu pra IGD, waktu masuk IGD dan penanganan operasi. Hipotesis penelitian adalah pengaruh dari keparahan cedera kepala terhadap kematian kasus >7 hari. Cedera lokasi anatomis lain merupakan variabel kontrol dan dianalisis bersama-sama. Penilaian keparahan cedera anatomis menggunakan skala Anatomic Profile (skala AP). Dari penilaian keparahan cedera fisiologis dengan nilai Revised Trauma Score (RTS). Hasil penelitian ini menunjukkan pengaruh nilai keparahan cedera kepala terhadap kematian kasus cedera >7 hari yaitu OR nilai AP 3,4,5,6 dan 7 dibandingkan nilai AP <3 masing-masing AP 3 (3-3.99) 1.14 kali (95* CI:0.27-4.86). nilai AP 4 (4-4.99) 1.30 kali (95% CI:0.39-4.32), nilai AP 5 (5-5.99) 4.84 kali (95% CI: 3..43-16.44), AP 6 (6-6.99) 8.49 kali (95% CI:2.33-30.92) dan nilai AP x7 12.20 kali (95k CI:2.64-56.43). OR lokasi lainnya dari cedera kepala (dengan skala kontinu) terdiri dari nilai keparahan cedera dada 1.18 kali (95% CI:0.84-1.64), cedera perut 1.65-kali (95% CI: 1.21-2.25) dan cedera lainnya 1.30 kali (95% CI:1.03-1.62). OR variabel kontrol lain adalah nilai keparahan cedera fisiologis 0.29 kali (95% CX:0.22-0.41) mekanisme cedera terdiri dari cedera jatuh 4.41 kali (95% CI:1.34-14.47) dan mekanisme cedera lain 1.73 kali (95% CI: 0.91-4.83) yang dibandingkan dengan mekanisme tabrakan kendaraan bermotor. Kemudian risiko waktu masuk IGD slang (jam 06.00-17.59) sebesar 2.00 kali (95% CI:1.11-3.59) dibandingkan masuk IGD malam-(jam 18.00-05.59) dan adanya penanganan operasi 0.16 kali (95% CI:0.07-0.38) dibandingkan yang tidak dioperasi. Saran yang dapat diberikan berdasarkan hasil penelitian adalah melakukan penilaian keparahan pasien cedera yang masuk IGD RSQPN CM dengan skala Anatomic Profile (AP) dan sekaligus dengan penilaian keparahan cedera fisiologis yaitu skala RTS (Revised Trauma Score). Penilaian ini berguna untuk evaluasi kualitas penanganan kasus cedera. Pengembangan penilaian keparahan. ini adalah dilakukan pada semua rumah sakit yang ada IGD. Daftar bacaan: 64 (1977-1995)
ABSTRACT The Association between the Degree of Anatomical Injury and Fatality of Injury Patients at the Emergency Department of DR. Cipto Mangunkusumo National General Hospital, Jakarta, January - December, 1993In the past decade, the incidence of injury, which is a non-infectious disease, increased and was termed the New Epidemic. In the developed countries it is called "The Neglected Disease of modern society.. Data from Indonesia and USA showed that injury is the fourth cause of death, especially among the younger age groups, which are the productive age groups and the future generation of Indonesia. Beside the magnitude of mortality, injury also causes increased morbidity, disability and invalidity. The objective of this study is to assess the association between the severity of anatomical injury and the fatality of injury patients at the Emergency Department of DR. Cipto Mangunkusumo General Hospital. It is anticipated that the results of this study would be useful for program managers and decision makers, and at the same time would contribute to the overall information on injury in Indonesia. The study was designed as a case-control study. Cases were fatal injury patients who died at the Emergency Department or who died within 7 days after admission. Control were injury patients who survived at least 7 days after admission. A total of 216 cases and 221 controls were obtained. No matching was performed. The odds ratio for fatality between cases and controls were calculated using multiple logistic regression method. The factors that were controlled for were: (1) subject characteristics (age, sex); (2) injury characteristics (anatomical injury severity, physiological injury severity, and type of injury mechanism) ; (3) injury management factors (referrals from other hospitals, means of transportation, length of pre-emergency periods, time of day the admission, and the fact of any definitive operation performed). The hypothesis to be tested was the association between of head injury and fatality. Injury of other anatomical areas were treated as separate variables for control and simultaneous associative analysis. The severity of anatomical injury was quantified using the Anatomic Profile Scale (AP scale) . The severity of physiological injury was quantified using Revised Trauma Score (RTS). Result of analysis showed that, as compared with injuries with AP score of c3 for head injuries, the injuries having an AP score of 3, 4, 5, 6, and 27 for head injuries had odds ratio of 1.14 (95% CI:0.27-4.86), 1.30 (95% CI:0.39-4.32), 4.84 (95% CI: 1.43-16.44), 8.49 (95% CI:2.33-30.92) and 12.20 (95% CI:2.64-56.43), respectively, after controlling for the other variables mentioned above. Odds ratio for injuries at other anatomical areas (whose AP scores treated as continuous variables) were: chest injury: 1.3.8 (95% CI:0.84-1.64), abdominal injury: 1.65 (95% CI:1.21-2.25), and other areas of injury: 1.30 (95% CI:1.03-1.62). Other odds ratio were: physiological injury severity (RTS score) : 0.29 (95% CI:0.22-0.41), injury mechanisms: fall: 4.41 (95% CI:1.34-14.47), others: 1.73 (95% CI:0.91-4.83) -(compared to motor vehicle injuries); admission during the day: 2.00 (95% CI:1.11-3.59) (compared to admission during the night)] having a definitive operation performed: 0.16 (95% CI:0.07-0.38) (compared to not having a definitive operation performed. The result of the study indicated the appropriateness of using the AP score and the RTS to asses the anatomical and physiological injury severity respectively. This scoring system should be implemented at the Emergency Departments of all hospitals to assist in the audit of emergency department performance. References: 64 (1977-1995)
Depok: Universitas Indonesia, 1997
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
<<   1 2   >>