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"Peningkatan kinerja, produktivitas dan keefektifan perusahaan merupakan usaha yang sulit, memerlukan kerja sama antara manajemen, karyawan dan perusahaan. Puskesmas Perawatan Merlung merupakan sarana layanan kesehatan di wilayahnya yang tentunya sangat dibutuhkan masyarakat setempat. Bila dilihat dari hasil evaluasi penilaian puskesmas dari tahun 2009 sampai 2011, pencapaian indikator Puskesmas Perawatan Merlung mengalami penurunan yaitu dari 45,17% pada tahun 2009 menjadi 37,79% pada tahun 2011.Penelitian ini bertujuan untuk mengetahui pengaruh langsung dan tidak langsung antara kepuasan kerja dan kepatuhan terhadap kinerja petugas layanan kesehatan di Puskesmas Perawatan Merlung.Penelitian ini merupakan penelitian observasional dengan menggunakan cross sectional study. Populasi penelitian adalah seluruh petugas Puskesmas Perawatan Merlung berjumlah 40 orang yang berhubungan langsung dengan pelayanan kesehatan. Dimensi kepuasan kerja, kepatuhan petugas dan kinerja diukur dengan menggunakan semantic differential scale, selain mengukur sikap dan karakteristik juga mengukur 5 dimensi pelayanan seperti tangibles, reliability, responsiveness, assurance dan empathy. Keseluruhan analisis menggunakan program SPSS ver. 20.0 dengan tingkat kemaknaan uji p<0,05.Hasil akhir dari keseluruhan analisis pada penelitian ini didapati regresi linier antara variabel kepuasan kerja terhadap variabel kinerja petugas, menunjukkan bahwa variabel kepuasan kerja sebagai prediktor untuk kinerja petugas. Oleh sebab itu perlu senantiasa perbaikan dan evaluasi dari kebijakan yang sudah ada untuk peningkatan kepuasan kerja dan kepatuhan petugas sehingga menghasilkan peningkatan kinerja yang baik terhadap pelayanan kesehatan.

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Improved performance, productivity and effectiveness of the company is a difficult undertaking, requiring cooperation between management, employees and the company. Merlung Service Health Care Center is a health care Facilities in the region are certainly much needed local community. When seen from the results of the evaluation assessment clinic from 2009 to 2011, the achievement indicators Merlung Service Health Care Center is decreased from 45.17% in 2009 to 37.79% in 2011.

This study aims to determine the direct and indirect influence between job satisfaction and compliance with the performance of the hospitality officer at Merlung Service Health Care Center.

This study is an observational research using cross sectional study. Population were all officers Merlung Service Health Care Centers are 40 people who are directly related to health care. Dimensions of job satisfaction, compliance officers, and performance was measured using semantic differential scale, in addition to measuring attitudes and characteristics were also measured 5 dimensions of service such as tangibles, reliability, responsiveness, assurance and empathy. Overall analysis using SPSS ver. 20.0 with a significance level of test p <0.05.

The end result of all this research is the analysis of the linear regression was found between job satisfaction variable on the variable performance officer, indicated that job satisfaction variables as predictors for performance officer. Therefore it is necessary to constantly repair and evaluation of existing policies to increase job satisfaction and compliance officers resulting performance improvement is good for health care services."

"Kepuasan penerima pelayanan tercapai bila pelayanan sesuai dengan yang dibutuhkan dan diharapkan. Kepuasan ibu hamil terhadap mutu layanan ANC dinilai dari 5 dimensi pelayanan tangibles, reliability, responsiveness, assurance dan empathy. Kinerja pelayanan KIA Puskesmas di Kota Jambi bila dilihat dari K1 sebesar 92,06% dan K4 sebesar 81,75%, angka ini telah melebihi dari target Nasional namun perspektif kepuasan ibu hamil masih ada yang menyatakan kurang puas. Penelitian ini dilakukan dalam ruang lingkup yang terbatas, yaitu mengkaji variabel kepatuhan bidan dalam standar pelayanan antenatal, karakteristik bidan dan karakteristik ibu hamil dengan tingkat kepuasan ibu hamil terhadap mutu layanan antenatal di Puskesmas se-Kota Jambi Tahun 2011. Penelitian ini merupakan penelitian observasional dengan menggunakan rancangan cross sectional study. Populasi penelitian adalah seluruh ibu hamil dan bidan, dan dilakukan penarikan sampel secara proportionate stratified random sampling yaitu ibu hamil sebanyak 105 orang dan bidan sebanyak 41 orang. Pengukuran kepuasan menggunakan pendekatan single global rating pada 5 dimensi pelayanan. Keseluruhan analisis menggunakan program SPSS ver. 13.0 dengan tingkat kemaknaan uji p<0,05. Nilai rerata dan simpangan baku kepuasan ibu hamil (-6,10±7,998) dan 59 subjek (56,2%) menyatakan puas, dan hasil analisis menunjukkan bahwa kepatuhan bidan berhubungan dengan kepuasan ibu hamil terhadap mutu layanan antenatal (p Wald = 8,469; p=0,003; OR (95% CI) = 5,143 (1,727-15,317)), paritas bumil (p Wald = 4,855; p=0,028; OR (95% CI) = 3,059 (1,132-8,272)) dan interaksi penghasilan dengan kepatuhan (p Wald = 7,779; p=0,005; OR (95% CI) = 0,203 (0,066-0,623)). Tingkat kepuasan ibu hamil terhadap mutu layanan antenatal dikategorikan puas, ada hubungan kepatuhan dengan kepuasan ibu hamil. Kepatuhan, paritas dan interaksi penghasilan dengan kepatuhan merupakan variabel prediktor untuk penilaian kepuasan ibu hamil terhadap mutu layanan antenatal, oleh karena itu perlu dilakukan refresh program ANC dan insentif khusus pada pelayanan antenatal.

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Satisfaction of service recipients achieved if the recipient to obtain medical services in Accordance with the required and expected. Satisfaction pregnant women to ANC ser-vices assessed the quality of the 5 dimensions of service tangibles, reliability, respon-siveness, assu-rance and empathy. Performance of MCH health centers in the city of Jambi when viewed from the K1 and K4 for 92.06% of 81.75%, this figure has ex-ceeded the national target, but the perspective of pregnant women still have the satisfaction that states are less satisfied.

The research was conducted within a limited scope, which is reviewing the variable standard of compliance with midwives in antenatal care, midwives characteristics and the characteristics of pregnant women with maternal levels of satisfaction for the qua-lity of antenatal care at the health center as Jambi City in 2011.

This study is an observational study using cross-sectional study design. The study po-pulation was all pregnant women and midwives, and sampling performed by propor-tionate stratified random sampling of pregnant women and midwives as many as 105 people as many as 41 people. Measurement of satisfaction using a single approach to a global rating on the five dimensions of service.

The entire analysis using SPSS ver. 13.0 with a significance level of test p <0.05.Mean 7.998)±value and standard deviation of maternal satisfaction (-6.10 and 59 subjects (56.2%) said they were satisfied, and the results of the analysis showed that the midwives compliance associated with maternal satisfaction for the quality of antenatal care (Wald p = 8.469; p = 0.003; OR (95% CI) = 5.143 (1,727-15,317)), parity pregnant women (p Wald = 4.855, p = 0.028; OR (95% CI) = 3.059 (1,132-8,272)) and the interaction of income with compliance (p Wald = 7.779, p = 0.005; OR (95% CI) = 0.203(0,066-0,623)).

Satisfaction levels of pregnant women to antenatal care quality categorized satisfied, there is a relationship of compliance with the satisfaction of pregnant women. Compliance, parity and income interactions with compliance is the predictor variable for the assessment of maternal satisfaction for the quality of antenatal care, therefore it is necessary to refresh the special incentive program and antenatal care."

"Infeksi nosokomial adalah infeksi yang terjadi selama penderita dirawat di rumah sakit dan sebelumnya tidak ada atau tidak dalam mass inkubasi penyakit infeksi tersebut. Akibat dari infeksi ini selain dapat meningkatkan mordibitas dan mortalitas serta lama perawatan dan biaya perawatan pasien, berpotensi pula menimbulkan tuntutan pengadilan.Ruang rawat intensif merupakan ruang perawatan dengan risiko yang tinggi untuk terjadinya infeksi nosokomial sehingga pencegahan dan pengendalian infeksi nosokomial di ruang ini perlu dilakukan, diantaranya melalui peningkatan perilaku kepatuhan petugas kesehatan dalam menjalankan prosedur tindakan medik/keperawatan dengan berprinsip pada teknik aseptik antiseptik dan kewaspadaan standar.Tujuan dari penelitian ini adalah untuk mernperoleh informasi tentang faktor - faktor yang berhubungan dengan perilaku pencegahan infeksi nosokomial pada tindakan medik dan keperawatan yang dilakukan oleh petugas kesehatan di ruang rawat intensif RS Medistra tahun 2004.Penelitian ini menggunakan desain observasional non eksperimental dengan rancangan survei cross sectional. Besar sampel sebanyak 65 orang yang terdiri dari Dokter Spesialis, Dokter Umum dan Perawat yang melakukan tindakan medikl keperawatan di ruang rawat intensif RS Medistra dari tanggal 15 Maret - 15 Mei 2004.Dari penelitian ini didapatkan bahwa perilaku pencegahan infeksi nosokomial responden di ruang rawat intensif RS Medistra berada pada kategori baik sebanyak 32 (49,2%) orang dan kurang baik sebanyak 33 (50,8%) orang.Selanjutnya dari uji Chi - square, independent t test, uji ANOVA dan korelasi terbukti bahwa :I. Variabel faktor predisposisi : pengetahuan berhubungan secara signifikan dengan perilaku pencegahan infeksi nosokomial, sementara variabel tingkat pendidikan dan sikap tidak berhubungan.II. Variabel faktor pemungkin : ketersediaan fasilitas berhubungan secara signifikan dengan perilaku pencegahan infeksi nosokomial, sementara variabel lama bekerja tidak berhubungan.III. Variabel faktor penguat : pelatihan dan pengawasan tidak berhubungan dengan perilaku pencegahan infeksi nosokomial.Dari hasil analisis multivariat didapatkan bahwa variabel pengetahuan dan fasilitas merupakan variabel yang berhubungan secara signifikan, namun dari kedua variabel ini ketersediaan fasilitas merupakan faktor yang paling dominan berhubungan dengan perilaku pencegahan infeksi nosokomial pada tindakan medik/ keperawatan di ruang rawat intensif RS Medistra tahun 2004 dengan OR 3,23 (CI: 1,09 - 9,57).Untuk mencegah terjadinya infeksi nosokomial di ruang rawat intensif RS Medistra disarankan agar Manajemen RS Medistra meningkatkan pengetahuan petugas kesehatan khususnya Dokter dan Perawat, melalui sosialisasi Standard Operating Procedure ruang rawat intensif secara terus-menerus dan berkelanjutan terutama tentang pentingnya kesehatan dan kebersihan tangan, langkah mencuci tangan dan menggosok tangan dengan benar serta pembenahan fasilitas cuci tangan yang ada.

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Factors Related to Behavior of Health Workers in Preventing the Nosocomial Infection in Medistra Hospital Intensive Ward, 2004

Nosocomial infection occurs when the patient is hospitalized and having no previous infection or incubation period. This nosocomial infection causes the increasing level of morbidity as well as mortality, hospitalization cost. length of stay and potentially create lawsuit.

Intensive ward is a high-risk potential area for the nosocomial infection to take place, so that prevention and control strategies are extremely required in this area_ One of the strategies is to constantly improve the behavior of health workers. the obedience following the standard medical/nursing procedure in aseptic-antiseptic technique and applying the universal precaution.

The objective of this research is to gain information about factors that are related to the health workers' behavior in their effort to prevent this nosocomial infection, and their submission in following the standard medical/nursing done in Medistra Hospital intensive ward, 2004.

This research used a non-experimental observation, with the cross sectional survey design. The research samples involves 65 participants : Specialist Doctors, General Doctors and Nurses who are in charge in the intensive ward during the period of March 15 until May 15, 2004.

From this research, we could get a conclusion based on the health workers' conduct in preventing the nosocomial infection done in Medistra Hospital intensive ward. It was concluded into two performance categories : 32 (49,2%) health workers with good performance and 33 (50,8%) health workers with less performance.

The Chi-square test, independent t test, ANOVA test and correlation regression test have proven :

I. Predisposing factors variable : knowledge is significantly related to anticipation behavior of the nosocomial infection, while there is no significant relation with education level and attitudes.

II. Enabling factors variable : supporting facilities are significantly related to anticipation behavior of the nosocomial infection, while there is no significant relation with the length of work.

III. Reinforcing factors variable : training and supervision have no significant relation with the anticipation behavior of the nosocomial infection,

Multivariate analysis has shown that both knowledge and facilities were variables that significantly related to anticipation behavior of the nosocomial infection, but the most dominant factor related to anticipation behavior of this nosocomial infection in Medistra Hospital intensive is supporting facilities with OR 3,23 (CI : 1,09 - 9,57).

In conclusion, to prevent the nosocomial infection in Medistra Hospital intensive ward, we recommend the hospital management to run serious efforts by continually increasing the knowledge of doctors and nurses, with intensive information of the standard operating procedure. The important of sanitary hand, how to clean and wash their hands regularly in correct ways are also necessary. We also suggest the improvement of hand washing facilities in Medistra hospital intensive ward."

"Kolaborasi interprofesional merupakan hal penting dalam pelayanan perawatan. Stereotip dianggap sebagai hambatan dalam penerapan kolaborasi interprofesional. Artikel ini merupakan hasil penelitian yang bertujuan untuk membuktikan adanya hubungan stereotip terhadap implementasi kolaborasi tenaga kesehatan di RSUD Pasar Rebo. Penelitian ini menggunakan metoda deskriptif analitik cross sectional. Responden penelitian ini yaitu dokter, perawat, ahli gizi, dan farmasis (N=88). Sampel penelitian diambil dengan cara stratified random sampling. Penelitian menggunakan Student Stereotypes Rating Questionnaire (SSRQ) dan Assessment of Interprofessional Team Collaboration Scale (AITCS) sebagai instrumen penelitian. Hasil penelitian menunjukkan adanya hubungan antara stereotip terhadap implementasi kolaborasi tenaga kesehatan (p=0.009; α=0.05). Analisis bivariat menunjukkan stereotip kategorik rendah berdasarkan 9 poin yang ada di SSRQ dan implementasi kolaborasi buruk berdasarkan partnership/shared decision making, coorperation, dan coordination mendominasi. Rekomendasi penelitian ini adalah perlu dilakukan penelitian lebih lanjut, mengupayakan meningkatkan hubungan interpersonal dengan tenaga kesehatan lainnya melalui pendekatan pemahaman peran masing-masing tenaga kesehatan dan memfasilitasi upaya tersebut merupakan hal yang penting.

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Interprofessional collaboration is essential in healthcare. Stereotype are considered as barrier for interprofessional collaboration practice. This aim of this article is to prove the significant correlation between stereotype and interprofessional collaboration practice in RSUD Pasar Rebo. Cross sectional analytical was used in this study. Participants were healthcare provider which consist of physician, nurse, pharmacy, and dietitian in RSUD Pasar Rebo (N=88). This study used Student Stereotypes Rating Questionnaire (SSRQ) and Assessment of Interprofessional Team Collaboration Scale (AITCS) as its instrument. Sample were taken by stratified random sampling.

This study showed there is correlation between stereotype with interprofessional collaboration practice (p=0.009; α=0.05). The result of bivariate analysis showed that low stereotype based on 9 point in SSRQ and bad implementation interprofessional collaboration based on partnership/shared decision making, cooperation, and coordination dominates. Based on result, to do other research is needed, the effort to do more in interpersonal relationship with understanding of each role member team, and facilitate this effort is important."

"Kunjungan Puskesmas Sarolangun mengalami penurunan selama 3 tahun terakhir. Survey awal yang dilakukan didapatkan hasil kepuasan pasien terhadap mutu layanan yang diberikan sebesar 40 %. Sementara menurut Petugas Puskesmas Sarolangun mereka mengganggap telah memberikan pelayanan dengan baik dan memuaskan. Untuk itu perlu dilakukan penelitian tentang perbedaan persepsi antara pasien dengan petugas tentang mutu layanan yang diberikan. Hasil penelitian diperoleh persepsi antara pasien dengan petugas dari dimensi tangible hampir sama, kecuali dalam hal prosedur pelayanan , rata-rata persepsi pasien lebih rendah dibandingkan dengan persepsi petugas dan perbedaan ini bermakna secara statistic. Dimensi reliability , persepsi antara pasien dengan petugas hampir sama, kecuali dalam hal penjelasan informasi tentang penyakit pasien dan sistim adminisrasi puskesmas rata-rata persepsi pasien lebih rendah dibandingkan dengan persepsi petugas dan perbedaan ini bermakna secara statistik. Persepsi pasien dan petugas dari dimensi responsibility ada perbedaan yang signifikan secara statistik, terutama pertanyaan mengenai kecepatan petugas menangani keluhan, petugas selalu memberi kemudahan saat melayani dan waktu tunggu yang cepat. Persepsi pasien dengan petugas untuk dimensi assurance terlihat ada perbedaan yang signifikan secara statistik pada pertanyaan mengenai keramahan kesabaran kesopanan dan pemeriksaan sebelum menyerahkan resep. Persepsi Kepuasan pasien dengan petugas dari dimensi empaty tidak bermakna secara statistik kecuali untuk pertanyaan mengenai perhatian petugas secara individua, persepsi pasien lebih rendah dibandingkan persepsi petugas. Dari hasil Fokus Grup Diskusi pada dua kelompok petugas terhadap komponen yang bermakna didapatkan hasil bahwa penyebab yang menjadi latar belakang perbedaan adalah perbedaan faktor individual petugas dan pasien , suasana lingkungan kerja ,beban kerja serta keterbatasan sarana dan kewenangan yang dimiliki. Hasil Penelitian diatas dapat disarankan kepada Puskesmas Sarolangun perlu meningkatkan mutu layanan terutama pada aspek dimensi Responsiveness dan assurance, serta berusaha memecahkan masalah yang menjadi latar belakang penyebab perbedaan seperti hasil Fokus Grup Diskusi.

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Sarolangun health center visits declined during the last 3 years. Initial survey of patient satisfaction results obtained for the quality of services provided by 40%. Meanwhile, according to officials they consider Sarolangun Health Center has provided good service and satisfying. For that we need to do research on the differences between patients with the officer's perception about the quality of services provided.

The results obtained among patients with the officer's perception of the tangible dimension is almost the same, except in the case of service procedures, patient perception of the average lo-wer than the perceptions of officers and this difference was statistically significant. The dimen-sions of reliability, the perception among patients with officers about the same, except in terms of explanation and information about the patient's disease clinic system adminisrasi patient's per ception of the average lower than the perceptions of officers and this difference was statistically significant. Patient's perception of the dimension of responsibility and the officers there was a statistically significant difference, especially questions about the speed of handling complaints officer, the officer always provide convenience when serving and waiting times are fast. Perceptions of patients with officers for assurance dimension appears there was a statistically significant difference on the question of patience, politeness and friendliness checks before handing the recipe. Patient satisfaction with the officer's perception of the dimension empaty not statistically significant except for the question regarding the officer's attention by individual, lower than the patient's perception of officers of perception.

From the results of Focus Group Discussions in two groups of workers against the significant components showed that the cause of the difference is the difference in background factors and the patient's individual officers, the atmosphere of work environment, workload and limited means and authority possessed.

The results of the above studies can be recommended to the Health Center Sarolangun need to improve the quality of services especially in the dimensions Responsivnes and assurance, as well as trying to solve a problem the background causes of differences such as the Focus Group Discussion."

"Kepuasan pasien dapat di ukur menggunakan lima dimensi kepuasan (keandalan, ketanggapan, jaminan, empati, produk-produk fisik). Penelitian ini bertujuan untuk mengetahui kepuasan mahasiswa terhadap pelayanan Pusat Kesehatan Mahasiswa Universitas Indonesia (PKM UI) setelah dilakukan upaya perbaikan pelayanan. Desain penelitian ini adalah deskriptif sederhana. Teknik pengambilan sampel (n=106) menggunakan consecutive sampling. Hasil penelitian ini menunjukkan bahwa mahasiswa yang puas terhadap pelayanan PKM UI hanya sebesar 45%. Sebesar 57% puas pada dimensi ketanggapan, 52,38% puas pada dimensi jaminan, 42,80% puas pada dimensi kehandalan, 42,40% puas pada dimensi empati, dan 45,30% puas pada dimensi produk-produk fisik.

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Patient satisfaction can be measured using five dimensions of satisfaction (reliability, responsiveness, assurance, empathy, tangibles). This research aims to know student satisfaction about service of health care student center of Universitas Indonesia (PKM UI) after service improvement done by PKM UI. Design for this research was simple descriptive. The technique of sampling (n = 106) used consecutive sampling. The research showed that students who were satisfied to PKM UI’s services only 45%. 57% satisfied in dimension responsiveness, 52,38% satisfied in dimension assurance, 42,80% satisfied in dimension reliability, 42,40% satisfied in dimension empathy, and 45,30% satisfied in dimension tangibles."

"Petugas layanan kesehatan adalah landasan dari setiap sistem layanan kesehatan yang berfungsi, mendedikasikan diri mereka untuk perawatan pasien dan meningkatkan kesehatan masyarakat. Namun, dedikasi mereka harus dibayar mahal karena lingkungan kerja membuat mereka terpapar banyak bahaya pekerjaan. Studi cross-sectional ini menggunakan metode campuran untuk menilai kesadaran kesehatan dan keselamatan kerja (OHS) di kalangan petugas kesehatan di Distrik Shamva, Zimbabwe. Kuesioner (α=0,773) diberikan kepada 102 petugas kesehatan, ukuran sampel dihitung menggunakan Epi Info berdasarkan populasi 139 dengan tingkat kepercayaan 95% dan margin kesalahan 5%. Wawancara dengan informan kunci melengkapi data kuantitatif. Studi ini mengungkapkan tingginya tingkat kesadaran K3, khususnya mengenai bahaya biologis, namun mengidentifikasi tantangan dalam implementasi karena kurangnya pelatihan, keterbatasan sumber daya, dan kebutuhan akan program K3 yang komprehensif. Bahaya yang umum terjadi antara lain cedera akibat tertusuk jarum suntik, infeksi, pemicu stres psikososial, pelecehan seksual, jam kerja yang panjang, serta terpeleset dan jatuh. Peserta merasakan program pelatihan keselamatan yang ada bermanfaat dalam mengurangi bahaya dan mengurangi cedera. Studi tersebut merekomendasikan revitalisasi program K3 dengan dukungan manajerial, mengintegrasikan protokol pencegahan dan pengendalian infeksi, melakukan pemeriksaan kesehatan secara berkala, dan melaksanakan pelatihan komprehensif yang mencakup seluruh bahaya K3. Temuan ini menggarisbawahi perlunya pendekatan multifaset untuk meningkatkan K3 di Distrik Shamva, memastikan kesejahteraan tenaga kesehatannya.

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Healthcare workers are the cornerstone of any functioning healthcare system, dedicating themselves to patient care and promoting community health. However, their dedication comes at a cost, as their work environment exposes them to a multitude of occupational hazards. This cross-sectional study uses mixed-methods to assess occupational health and safety (OHS) awareness among healthcare workers in Shamva District, Zimbabwe. A questionnaire (α=0.773) was administered to 102 healthcare workers, a sample size calculated using Epi Info based on a population of 139 with a 95% confidence level and a 5% margin of error. Interviews with key informants supplemented the quantitative data. The study revealed a high level of OHS awareness, particularly regarding biological hazards, but identified challenges in implementation due to inadequate training, resource constraints, and the need for comprehensive OHS programs. Common hazards included needle stick injuries, infections, psychosocial stressors, sexual harassment, long working hours, and slips and falls. Participants perceived existing safety training programs as beneficial in mitigating hazards and reducing injuries. The study recommends revitalizing OHS programs with managerial support, integrating infection prevention and control protocols, conducting regular medical examinations, and implementing comprehensive training that covers all OHS hazards. These findings underscore the need for a multifaceted approach to improve OHS in Shamva District, ensuring the well-being of its healthcare workforce."

"Latar belakang: Pengembangan pengetahuan dan keterampilan petugas kesehatan di Puskesmas masih belum rutin dilakukan, sehingga umumnya belum mampu melakukan tatalaksana awal pada bayi bermasalah.Tujuan: Mengetahui pengetahuan dan keterampilan petugas kesehatan di Puskesmas wilayah Tangerang mengenai resusitasi, stabilisasi, dan transportasi neonatal, menganalisis faktor-faktor yang memengaruhinya, serta mengetahui profil SNAPPE II neonatal yang dirujuk dari Puskesmas tersebut.Metode: Metode yang digunakan adalah mixed method yaitu penelitian kuantitatif desain kuasi-eksperimental (pretest-posttest) yang menilai pengetahuan dan keterampilan petugas kesehatan, serta SNAPPE II neonatal yang dirujuk sebelum dan sesudah intervensi, disertai pendalaman kualitatif melalui wawancara sistem kesehatan meso dan makro, serta focus group discussion sistem kesehatan mikro.Hasil: Penelitian dilakukan di 12 puskesmas wilayah Tangerang, dengan subjek 36 petugas kesehatan, dan wawancara mendalam kepada 17 sistem kesehatan meso dan makro. Pengetahuan dan keterampilan petugas kesehatan mengalami peningkatan bermakna sebelum dan sesudah pelatihan (p<0,001 dan p=0,002), namun nilai rerata stabilisasi dibawah batas lulus. Dalam pemantauan selama 3 bulan pasca pelatihan, retensi keterampilan penanganan kegawatan neonatal cukup baik dan didapatkan perbedaan bermakna sebelum dan sesudah intervensi (p<0,001). Pada VTP terdapat perbedaan bermakna dengan penurunan di bulan kedua (90,4 dan meningkat kembali di bulan ketiga (93.5sedangkan nilai rerata pemberian CPAP dan stabilisasi selalu dibawah batas lulus. Nilai SNAPPE II pada neonatal yang dirujuk ke rumah sakit menunjukkan perbaikan prognosis yang bermakna secara statistik (p=0,013). Analisis kualitatif menemukan 3 akar masalah utama yaitu keterbatasan sumber daya manusia, kualifikasi SDM yang belum mengikuti pelatihan maupun resertifikasi, dan monitoring evaluasi berkelanjutan, dengan 3 alternatif solusi berupa pelatihan dan update klinis berbasis teknologi (daring), pendampingan Dokter Spesialis Anak (Konsultan Neonatologi), serta supervisi Dinas terkait bekerjasama dengan organisasi profesi.Simpulan: Terdapat perbedaan bermakna pengetahuan dan keterampilan petugas kesehatan di Puskesmas wilayah Tangerang mengenai resusitasi, stabilisasi, dan transportasi neonatal sebelum (pretest) dan sesudah (posttest) intervensi. Terdapat tiga faktor utama yang memengaruhi pengetahuan dan keterampilan petugas kesehatan antara lain jumlah SDM, kualifikasi SDM dan monitoring evaluasi yang berkesinambungan. Terdapat peningkatan profil SNAPPE II pada neonatal yang dirujuk ke rumah sakit oleh Puskesmas yang dilatih sesudah intervensi dibandingkan sebelumnya

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Background: The development of knowledge and skills of health workers at public health centers is not yet routinely carried out, so generally they are not able to carry out initial management of neonatal emergencies.

Objective: To determine the knowledge and skills of health workers at Tangerang district public health centers regarding neonatal resuscitation, stabilization and transportation, to analyze the influencing factors, and to determine the profile of SNAPPE II neonates referred from the public health centers.

Methods: A mixed method, quantitative research with a quasi-experimental design (pretest-posttest) that assesses the knowledge and skills of health workers, SNAPPE II for referred neonates before and after intervention, accompanied by qualitative deepening through interviews of meso and macro health systems, and focus group discussion on micro health systems.

Result: The study was conducted in 12 public health centers in Tangerang area, with 36 health workers as subjects, and in-depth interviews with 17 meso and macro health systems. Knowledge and skills of health workers experienced a significant increase before and after training (p<0.001 and p=0.002), but the mean value of stabilization was below the pass threshold. In monitoring for 3 months after training, the retention of neonatal emergency handling skills was quite good and there were significant differences before and after intervention (p<0.001). In VTP there is a significant difference with a decrease in the second month (90.4 ± 9.0) and increase again in the third month (93.5 ± 7.8), while the mean value of CPAP and stabilization is always below the pass limit. The SNAPPE II value for neonatal admissions to hospital showed a statistically significant improvement in prognosis (p=0.013). Qualitative analysis found 3 main root problems, namely limited human resources, qualifications of human resources who have not attended training or recertification, and continuous evaluation monitoring, with 3 alternative solutions in the form of training and technology-based clinical updates (online), assistance of Pediatricians (Neonatology Consultants), and the supervision of related agencies in collaboration with professional organizations.

Conclusion: There were significant differences in the knowledge and skills of health workers at the Tangerang district public health centers regarding resuscitation, stabilization, and neonatal transportation before (pretest) and after (posttest) intervention. There are three main factors that affect the knowledge and skills of health workers, including the number of human resources, qualifications of human resources and continuous monitoring and evaluation. There is an increase in the SNAPPE II profile among neonates referred to hospital by public health centers trained after intervention compared to before."

"Latar belakang: Pengembangan pengetahuan dan keterampilan petugas kesehatan di Puskesmas masih belum rutin dilakukan, sehingga umumnya belum mampu melakukan tatalaksana awal pada bayi bermasalah. Tujuan: Mengetahui pengetahuan dan keterampilan petugas kesehatan di Puskesmas wilayah Tangerang mengenai resusitasi, stabilisasi, dan transportasi neonatal, menganalisis faktor-faktor yang memengaruhinya, serta mengetahui profil SNAPPE II neonatal yang dirujuk dari Puskesmas tersebut. Metode: Metode yang digunakan adalah mixed method yaitu penelitian kuantitatif desain kuasi-eksperimental (pretest-posttest) yang menilai pengetahuan dan keterampilan petugas kesehatan, serta SNAPPE II neonatal yang dirujuk sebelum dan sesudah intervensi, disertai pendalaman kualitatif melalui wawancara sistem kesehatan meso dan makro, serta focus group discussion sistem kesehatan mikro. Hasil: Penelitian dilakukan di 12 puskesmas wilayah Tangerang, dengan subjek 36 petugas kesehatan, dan wawancara mendalam kepada 17 sistem kesehatan meso dan makro. Pengetahuan dan keterampilan petugas kesehatan mengalami peningkatan bermakna sebelum dan sesudah pelatihan (p<0,001 dan p=0,002), namun nilai rerata stabilisasi dibawah batas lulus. Dalam pemantauan selama 3 bulan pasca pelatihan, retensi keterampilan penanganan kegawatan neonatal cukup baik dan didapatkan perbedaan bermakna sebelum dan sesudah intervensi (p<0,001). Pada VTP terdapat perbedaan bermakna dengan penurunan di bulan kedua (90,4 ± 9,0) dan meningkat kembali di bulan ketiga (93.5 ± 7,8), sedangkan nilai rerata pemberian CPAP dan stabilisasi selalu dibawah batas lulus. Nilai SNAPPE II pada neonatal yang dirujuk ke rumah sakit menunjukkan perbaikan prognosis yang bermakna secara statistik (p=0,013). Analisis kualitatif menemukan 3 akar masalah utama yaitu keterbatasan sumber daya manusia, kualifikasi SDM yang belum mengikuti pelatihan maupun resertifikasi, dan monitoring evaluasi berkelanjutan, dengan 3 alternatif solusi berupa pelatihan dan update klinis berbasis teknologi (daring), pendampingan Dokter Spesialis Anak (Konsultan Neonatologi), serta supervisi Dinas terkait bekerjasama dengan organisasi profesi. Simpulan: Terdapat perbedaan bermakna pengetahuan dan keterampilan petugas kesehatan di Puskesmas wilayah Tangerang mengenai resusitasi, stabilisasi, dan transportasi neonatal sebelum (pretest) dan sesudah (posttest) intervensi. Terdapat tiga faktor utama yang memengaruhi pengetahuan dan keterampilan petugas kesehatan antara lain jumlah SDM, kualifikasi SDM dan monitoring evaluasi yang berkesinambungan. Terdapat peningkatan profil SNAPPE II pada neonatal yang dirujuk ke rumah sakit oleh Puskesmas yang dilatih sesudah intervensi dibandingkan sebelumnya.

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Background: The development of knowledge and skills of health workers at public health centers is not yet routinely carried out, so generally they are not able to carry out initial management of neonatal emergencies.

Objective: To determine the knowledge and skills of health workers at Tangerang district public health centers regarding neonatal resuscitation, stabilization and transportation, to analyze the influencing factors, and to determine the profile of SNAPPE II neonates referred from the public health centers.

Methods: A mixed method, quantitative research with a quasi-experimental design (pretest-posttest) that assesses the knowledge and skills of health workers, SNAPPE II for referred neonates before and after intervention, accompanied by qualitative deepening through interviews of meso and macro health systems, and focus group discussion on micro health systems.

Result: The study was conducted in 12 public health centers in Tangerang area, with 36 health workers as subjects, and in-depth interviews with 17 meso and macro health systems. Knowledge and skills of health workers experienced a significant increase before and after training (p<0.001 and p=0.002), but the mean value of stabilization was below the pass threshold. In monitoring for 3 months after training, the retention of neonatal emergency handling skills was quite good and there were significant differences before and after intervention (p<0.001). In VTP there is a significant difference with a decrease in the second month (90.4 ± 9.0) and increase again in the third month (93.5 ± 7.8), while the mean value of CPAP and stabilization is always below the pass limit. The SNAPPE II value for neonatal admissions to hospital showed a statistically significant improvement in prognosis (p=0.013). Qualitative analysis found 3 main root problems, namely limited human resources, qualifications of human resources who have not attended training or recertification, and continuous evaluation monitoring, with 3 alternative solutions in the form of training and technology-based clinical updates (online), assistance of Pediatricians (Neonatology Consultants), and the supervision of related agencies in collaboration with professional organizations.

Conclusion: There were significant differences in the knowledge and skills of health workers at the Tangerang district public health centers regarding resuscitation, stabilization, and neonatal transportation before (pretest) and after (posttest) intervention. There are three main factors that affect the knowledge and skills of health workers, including the number of human resources, qualifications of human resources and continuous monitoring and evaluation. There is an increase in the SNAPPE II profile among neonates referred to hospital by public health centers trained after intervention compared to before."