Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKAnalisis Sistem merupakan penguraian operasional suatu sistem yang meliputiupaya pengidentifikasian tujuan, kegiatan, pelaksanaan kegiatan, situasi yangdihadapi serta informasi yang dibutuhkan sistem disetiap tahap pelaksanaannya.Penelitian ini menggunakan pendekatan perpaduan Teori Sistem Donabedian-Azwar, dengan pokok tahapan Struktur/Input-Proses-Output/Outcome untukmelihat sistem pelayanan penyakit jantung di RSUD Dr.Kanujoso DjatiwibowoBalikpapan Tahun 2014. Penelitian dilakukan pada bulan April hingga Nopember2015, menggunakan rancangan kualitatif dengan metode deskriptif analitik.Analisis dilakukan dengan data bersumber dari telaah dokumen medik pasienpenyakit jantung di RSUD Dr Kanujoso Djatiwibowo Balikpapan tahun 2014,observasi dan wawancara mendalam terhadap informan terpilih. Hasil penelitianmenunjukan faktor dari Struktur/Input yang berpengaruh terhadap mortalitadalam sistem pelayanan penyakit jantung di RSUD Dr Kanujoso DjatiwibowoBalikpapan adalah faktor Pasien, SDM, Fasilitas, dan Metode. Faktor Prosesberupa proses pemberian pelayanan, koordinasi dokter-perawat dan keterpaduanlayanan. Disarankan agar pihak RSUD Dr Kanujosos Djatiwibowo Balikpapanmelakukan penambahan tenaga dokter Spesialis Jantung, membuat pelayanan satuatap pasien penyakit jantung/Cardiac Center dan meningkatkankerjasama/koordinasi yang baik antara pihak RSUD Dr Kanujosos Djatiwibowodengan Faskes Pelayanan Primer, Dinas Kesehatan Kota Balikpapan dan pihakrumah sakit lainnya yang ada di Kota Balikpapan.

---

ABSTRACTDecomposition Analysis System is operating a system that includes identificationefforts objectives, activities, implementation of activities, the situation faced andinformation needed at each stage of system implementation. This study uses ablend of Systems Theory approach Donabedian-Azwar, the principal stages ofStructural / Input-Process-Output / Outcome to look at heart disease care systemin hospitals Dr.Kanujoso Djatiwibowo Balikpapan 2014. The study wasconducted from April to November 2015, using a design qualitative descriptiveanalytic method. Analysis was performed with the data derived from the study ofmedical documents cardiac patients in hospitals Dr Kanujoso DjatiwibowoBalikpapan in 2014, observation and depth interview with selected informants.The results showed a factor of structure / Inputs that influence mortality incardiovascular disease care system in the Hospital Dr Kanujoso DjatiwibowoBalikpapan is Patient factors, human resources, facilities, and methods. Factorssuch as the process of service delivery, the doctor-nurse coordination andintegration of services. It is recommended that the hospitals Dr KanujososDjatiwibowo Balikpapan perform additional doctors Heart Specialist, create onestopservice for cardiovascular disease / Cardiac Center and increase cooperation /coordination between the hospitals Dr Kanujosos Djatiwibowo with PrimaryHealth Care Facility, City Health Department Balikpapan and house parties otherhospitals in the city of Balikpapan."

"ABSTRAKNama : Achmad Zuhro Ma rsquo;rufProgram Studi : Kajian Administrasi Rumah SakitJudul Tesis :Analisis Pelaksanaan Fungsi Komite Medik di RSUD dr. Kanujoso Djatiwibowo,Balikpapan Periode 2014-2016Penelitian ini bertujuan untuk menggali faktor-faktor yang mempengaruhipelaksanaan fungsi Komite Medik di RSUD dr. Kanujoso Djatiwibowo, Balikpapansesuai dengan PMK No 755 tahun 2011. Desain penelitian adalah kualitatif studikasus. Responden penelitian Komite Medik periode 2014-2018 dan stake holderrumah sakit.Hasil penelitian menunjukkan pelaksanaan fungsi Komite Medik belum maksimal.Faktor-faktor yang mempengaruhi pada tingkat individu usia, spesialisasi,pengalaman, tugas rangkap, pelatihan , kelompok iklim kerja, kepemimpinan,sarana prasarana, pengambilan keputusan, penghargaan, komunikasi, targetkinerja dan organisasi hospital bylaws dan stake holder .Rekomendasi perbaikan dengan penyempurnaan hospital bylaws corporate danmedical staff dan memperbaiki sistem di Komite Medik.Kata kunci :Komite Medik, PMK No.755 tahun 2011, Hospital Bylaws, Medical Staff Bylaws

---

ABSTRACTName Achmad Zuhro Ma rsquo rufStudy Program Kajian Administrasi Rumah SakitTitle Analysis of The Implementation of Medical Committee Functions in RSUD dr.Kanujoso Djatiwibowo, Balikpapan Period 2014 2016The aim of this study is to explore the factors that affect the implementation of thefunctions of the Hospital Medical Committee in dr. Kanujoso Djatiwibowo GeneralHospital, Balikpapan, accordance with Minister of Health Regulation Number 755of 2011.The design of this study is a qualitative case study. The respondents are TheCommittee rsquo s members for the period 2014 2018 and the stake holder of thehospital.The result shows that the implementation of Hopital Medical Committee rsquo sfunctions are not maximal yet. The influencing factors are at the individual level age, specialization, experience, double task, training , group level work climate,leadership, infrastructure, decision making, awards, communication, performance and organization level hospital bylaws and stakeholders .Recommendations are improving hospital bylaws corporate and medical staff andimproving systems in the Medical Committee.Kata kunci Medical Committee, PMK No.755 tahun 2011, medical staf bylaws"

"Gagal jantung diakibatkan oleh gangguan struktur atau fungsi jantung yang merusak kemampuan ventrikel untuk mengisi atau memompa darah. Gagal jantung paling banyak ditemukan pada masyarakat perkotaan akibat gaya hidup yang tidak sehat, seperti merokok, mengkonsumsi makanan berlemak, kurang aktivitas, dan stress. Intoleran aktivitas merupakan salah satu masalah keperawatan yang ditemukan pada pasien gagal jantung, dimana klien merasa cepat lelah saat beraktivitas akibat pasokan darah dan oksigen ke organ terganggu. Karya ilmiah ini bertujuan untuk menganalisis asuhan keperawatan masyarakat perkotaan pada pasien gagal jantung kronik dengan penerapan intervensi latihan aktivitas fisik secara bertahap. Metode yang digunakan berupa studi kasus dengan satu pasien kelolaan berusia 60 tahun, berjenis kelamin wanita yang diberikan intervensi latihan aktivitas fisik secara bertahap selama 6 hari. Hasil intervensi berupa peningkatan aktivitas klien dari bedrest sampai berjalan 80 langkah, tanpa sesak maupun kelelahan. Intervensi latihan aktivitas fisik secara bertahap direkomendasikan untuk diterapkan di unit layanan keperawatandengan kondisi pasien stabil atau sudah melewati fase akut, untuk mengatasi intoleran aktivitas pada pasien gagal jantung kronik.

---

Heart failure is caused by impairment in cardiac structure or function which disrupts ventricle capacity to load or pump blood. Heart failure commonly affects urban community with unhealthy lifestyle, including smoking, fat consumption, lack of physical activity, and stress. Activity intolerance is a nursing diagnosis that may be established for patient with heart failure in which client feels easily fatigued following activities due to altered supply of blood and oxygen into body organs.

This paper aimed to analyze urban community nursing care on patient with chronic heart failure by implementation of gradual physical exercise. The study method was case study of 60 year old female patient who was provided with gradual physical exercise for 6 days long.

The result suggested an improvement in client's activity from bed rest to be able to walk 80 steps, without exertional dyspnea and fatigue. Gradual physical exercise is recommended to be applied in nursing unit for patient with a stable condition or surviving the acute phase, in order to manage activity intolerance in patient with chronic heart failure."

"Effectively manage the chronic problems of your hypertensive patients with the practical clinical tools inside Hypertension, 2nd Edition: A Companion to Braunwald's Heart Disease. This respected cardiology reference covers everything you need to know - from epidemiology and pathophysiology through diagnosis, risk stratification, treatment, outcome studies, concomitant diseases, special populations and special situations, and future treatments. Confidently meet the needs of special populations with chronic hypertensive disease, as well as hypertension and concomitant disease. Learn new methods of aggressive patient management and disease prevention to help ensure minimal risk of further cardiovascular problems. Benefit from the authors' Clinical Pearls to reduce complications of hypertension"

"Tesis ini disusun untuk mengetahui pengaruh pemberian edukasi terhadap kepatuhan pasien penyakit jantung koroner dalam menjalani rehabilitasi jantung fase II di rumah. Penelitian ini menggunakan desain kuasi-eksperimental. Sebanyak 46 subjek penelitian pasien penyakit jantung koroner (pasca infark miokard atau pasien yang telah menjalani PCI maupun CABG) yang mampu berjalan mandiri dan dinyatakan mampu menjalani latihan di rumah, dibagi menjadi dua kelompok, yaitu kelompok perlakuan dan kelompok kontrol dengan masing-masing berjumlah 23 orang. Pada kelompok perlakuan diberikan edukasi mengenai rehabilitasi jantung fase II melalui penayangan video edukasi di rawat inap, pemberian pesan pengingat selama melakukan latihan di rumah, dan leaflet. Kelompok perlakuan melakukan latihan di rumah dengan frekuensi 3 kali/minggu selama 8 minggu. Kelompok kontrol hanya mendapatkan edukasi melalui leaflet saat di rawat inap, dan tetap disarankan untuk melakukan latihan di rumah dengan frekuensi yang sama dengan kelompok perlakuan. Pemantauan latihan dan kepatuhan dilakukan dengan logbook. Penelitian ini menunjukkan bahwa pemberian intervensi berupa edukasi memiliki pengaruh pada tingkat kepatuhan pasien penyakit jantung koroner dalam menjalani rehabilitasi jantung fase II di rumah, yang tergambar dari sesi latihan yang lebih tinggi pada kelompok intervensi (p=0.001). Angka kepatuhan (menjalani minimal 20 dari 24 sesi latihan) pada kelompok intervensi adalah sebesar 91%, sedangkan pada kelompok kontrol hanya 30%, dengan proporsi kepatuhan berbeda bermakna (p=0.001, RR 3,000 (1,597 – 5,636)).

---

This thesis was aimed to know the impact of educational intervention to compliance of coronary artery disease patients in doing home-based cardiac rehabilitation phase II. The study design was quasi-experimental. A total of 46 coronary artery disease patients who were able to walk independently and suitable in doing home-based exercise were divided into 2 groups, each consisted of 23 subjects. Subjects in intervention group were given educational intervention through video, short-text reminder messaging while doing home exercise, and leaflet. They were stated to do home exercise for 3 times/week for 8 weeks.

Subjects in control group only get educational leaflet, and stated to do the same home exercise regimen. Monitoring of exercise and adherence was done through logbook. This study showed that educational intervention could improve compliance in home-based exercise. The intervention group showed higher number 24(5-24) of exercise sessions (p=0.001). The compliance rate (defined as attending minimum 20 out of 24 sessions) in intervention group was 91%, while in control group 30%, with statistically significant difference."

"Latihan fisik yang dilakukan secara aktif berdampak positif terhadap tingkat kemandirian dalam memenuhi ADL nya. Penelitian ini bertujuan mengetahui hubungan antara latihan fisik berdasarkan jenis, frekuensi, dan durasi tingkat kemandirian ADL. Jenis penelitian ini adalah deskriptif analitik melalui pendekatan cross sectional dengan jumlah sampel 103 lansia riwayat penyakit jantung. Tingkat kemandirian lansia diukur menggunakan Indeks kemandirian Katz yang sudah dimodifikasi.. Hasil dari penelitian ini, lansia yang melakukan jenis latihan fisik dalam katagori cukup baik ( 69,9%). Tingkat kemandirian melakukan ADL dalam katagori mandiri (96,8%), dengan nilai OR 2.79, α 0,00 dan 95% CI : 1.14-1.57, artinya ada hubungan antara jenis latihan fisik dengan kemandirian melakukan ADL, untuk frekuensi latihan fisik dalam katagori sangat baik (65,1%). Tingkat kemandirian ADL dalam katagori mandiri (89,5%), dengan nilai OR 1,47, α 0,00 dan 95% CI : 1.12-1.93, artinya ada hubungan antara frekuensi latihan fisik dengan kemandirian melakukan ADL pada lansia yang mempunyai riwayat penyakit jantung. Hasil penelitian ini merekomendasikan bagi lansia yang mempunyai penyakit jantung untuk melakukan latihan fisik secara teratur sehingga membantu meningkatkan kemandirian ADL lansia.

---

Physical exercise is performed actively positive impact on the level of independence in fulfilling its ADL. This study aims to investigate the relationship between physical exercise based on the type, frequency, and duration of the level of independence of the ADL. This research is a descriptive cross sectional analytical approach with a sample of 103 elderly heart disease history. The level of independence of elderly Katz independence index is measured using a modified. The results of this study, elderly people who do this type of physical exercise in the category quite well (69.9%). Level of independence do ADL in the independent category (96.8%), with OR 2.79, α 0.00 and 95% CI: 1:14 to 1:57, meaning that there was a relationship between the type of physical exercise to perform ADL independence, to the frequency of physical exercise in the category very good (65.1%). ADL independence level in the category of independent (89.5%), with OR 1.47, α 0.00 and 95% CI: 1.12-1.93, which means that there is a relationship between the frequency of physical exercise to perform ADL independence in older people who have a history of disease heart. The results of this study recommend for the elderly who have heart disease to undertake regular physical exercise that helps increase the independence of elderly ADL."

"ABSTRAKPada penelitian ini dicari pengaruh dari Faktor Struktur dan Proses sebagai unsur mutu sesuai teori Donabedian terhadap Net Death Rate/ NDR dari penyakit Stroke. Sumber data yang terpilih berasal dari pasien Sroke berupa kasus Intracerebral haemorrhage dan Cerebral infarction di RSUD Dr Kanujoso Djatiwibowo Balikpapan pada tahun 2014. Penelitian bersifat kualitatif dengan metode deskriptif analitik menggunakan studi retrospektif. Didapatkan faktor struktur secara berurutan yang mempengaruhi adalah kondisi pasien, fasilitas, kebijakan dan sumber daya manusia. Sedangkan faktor proses terbanyak di Rawat Inap yang mempengaruhi adalah kendala dalam menjalankan instruksi serta adanya Infeksi Rumah Sakit/ IRS yang terjadi dalam proses perawatan. Di IRD faktor proses yang menjadi kendala adalah pelayanan pemeriksaan penunjang khusus nya CT Scan tidak selalu dapat dilakukan. Disarankan untuk melakukan peningkatan mutu pelayanan dengan memperbaiki kendala faktor struktur dan proses serta mengembangkan pelayanan satu atap Unit Stroke.

---

ABSTRACTThis study is seeking the impact of structure and process as the quality aspect according to Donabedian 's theory that affecting to the Net Death Rate/ NDR Stroke disease. Selected data source are Stroke patients, consisting of Intracerebral Haemorrhage and Cerebral Infarction at Dr Kanujoso Djatiwibowo Balikpapan Hospital in the year 2014. This study is a qualitative research using descriptive analytic retrospective method. Structure and Process Factors that are influencing each other. It reveals that Structure Factors in hospitalization that are affecting sequentially are the condition of the patient, facilities, policies and human resource. On the other hand it reveals that Process Factors include obstacle on running the primary instruction and also Hospital Accociated Infections/ HAIs occurs due to the nursing process. In Emergency Unit there is obstacle in Process Factor as the CT Scan service is not available sometime. It is recommend to improve the quality of Stroke patient to overcome the Structure and Process Factors and to develop the on stop service Stroke Unit."

"Latar belakang: Penyakit jantung bawaan merupakan jenis kelainan bawaan lahir paling umum, dan merupakan penyebab kematian tersering pada bayi. Sindrom curah jantung rendah masih merupakan masalah yang dihadapi pada subjek pediatrik pascaoperasi jantung terbuka. Deteksi sindrom curah jantung rendah dengan kriteria klinis dan indikator laboratorik masih dirasa belum cukup, yang terbukti dengan masih adanya angka morbiditas dan mortalitas. Peranan penanda biologis NT-proBNP diharapkan dapat digunakan untuk dapat mendeteksi sindrom curah jantung rendah pada pediatrik.Metode: Penelitian pendahuluan kohort retrospektif dengan jumlah 47 subjek yang memenuhi kriteria inklusi dan eksklusi yang menjalani pembedahan jantung terbuka paliatif; PA banding, Bidirectional cavopulmonary shunt, BT-shuntdan Fontan, pada periode Oktober 2019 hingga Maret 2020 di Rumah Sakit Jantung dan Pembuluh darah Nasional Harapan Kita, Indonesia. Data prabedah, intrabedah dan pascaoperasi termasuk kejadian sindrom curah jantung rendah dicatat. Kadar NT-proBNP akan diambil prabedah, 4 jam, 24 jam dan 72 jam pascaoperasi. Analisis data menggunakan uji Mann-Whitney. Hasil: Kadar NT-proBNP pada prosedur palitif khususnya Fontan pada prabedah (137 pg/ml), 4 jam pascaoperasi (685 pg/ml), 24 jam pascaoperasi (5.715 pg/ml), dan 72 jam pascaoperasi (970 pg/ml). Kadar NT-proBNP prabedah, 4 jam pascaoperasi, 24 jam pascaoperasi, dan 72 jam pascaoperasi tidak berbeda bermakna dengan kejadian sindrom curah jantung rendah (nilai p >0,05). Kesimpulan: Ditemukan peningkatan nilai NT-Pro BNP pada subjek pascaoperasi jantung paliatif khususnya Fontan dan bidirectional cavopulmonary shunt yang mengalami sindrom curah jantung rendah pada jam ke-24. Namun kesimpulan diatas masih berdasarkan jumlah sampel dengan kekuatan penelitian <80% sehingga hanya berlaku sebagai kesimpulan sementara berdasarkan studi pendahuluan.

---

Background: Congenital heart disease is the most common type of birth defects, and is the most common cause of death in infants. Cardiac syndrome is still a problem faced by pediatric patients after heart surgery. Detection of Low Cardiac Output Syndrome with clinical criteria and laboratory indicators is still considered insufficient, which is proven to still contain morbidity and mortality rates. The role of NT-proBNP biological markers is expected to be used to support the detection of low cardiac output syndrome in pediatrics.

Methods: A Preliminary retrospective cohort with 47 subjects fulfilling the inclusion and exclusion criteria who underwent palliative open heart surgery PA banding, Bidirectional cavopulmonary shunt, BT-shunt and Fontan from October, 2019 to March, 2020 at the Harapan Kita National Heart and Vascular Hospital, Indonesia. Preoperative, operative and postoperative data including the incidence of low cardiac output syndrome were recorded. NT-proBNP levels will be taken pre-surgery, 4 hours, 24 hours and 72 hours after surgery. Data analysis using the Mann-Whitney test.

Results: NT-proBNP levels in the cardiac palliative surgery especially Fontan procedure at pre-surgery (137 pg/mL), 4 hours after surgery (685 pg/mL), 24 hours after surgery (5,715 pg/mL), and 72 hours after surgery (970 pg/mL). NT-proBNP levels at pre-surgery, 4 hours after surgery, 24 hours after surgery, and 72 hours after surgery were not significantly different from the incidence of low cardiac output syndrome (p value> 0.05).

Conclusion: There is an increase in NT-Pro BNP values ​​in subjects with Fontan palliative heart surgery and bidirectional cavopulmonary shunt. However, the above conclusions are still based on the number of samples with research powers<80% and can only be taken as a provisional conclusion based on preliminary studies."