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"ABSTRAKPerkembangan teknologi informasi dan komunikasi telah banyak beredar informasi tentang penyakit pasien dalam bentuk foto dan video di berbagai media sosial Media mengangkat isu etik, yaitu pelanggaran rahasia medis. Namun, Kode Etik Kedokteran Indonesia (KODEKI) danUndang-undang Nomor 29 Tahun 2004 tentang Praktik Kedokteran dan peraturan perundang-undangan yang lain menyatakan bahwa dokter wajib menyimpan rahasia medis. Berdasarkan latar belakang tersebut, maka metode penelitian dalam Penulisan ini menggunakan metode penelitian yuridis-normatif, yaitu penelitian yang menekankan penggunaan norma hukum secara tertulis dan didukung dengan hasil wawancara dengan narasumber dan informan. Jenis penelitian yangdigunakan adalah analisis preskriptif, yaitu mengkaji atau mengkaji ketentuan-ketentuan peraturan perundang-undangan di bidang kedokteran dan implementasinya ke dalam rana empiris atau tatanan sosial. Dokter dan dokter gigi diharapkan untuk menggunakan media sosial secara bijak dengan mempertimbangkan aspek etik yang tertuang dalam Kode Etik Kedokteran Indonesia (KODEKI) danketentuan peraturan perundang-undangan yang berlaku di Indonesia. Dengan Dengan demikian, dokter harus dapat mempertanggungjawabkan perbuatannya dengan cara: penerapan sanksi etik, sanksi disiplin dan sanksi hukum.ABSTRACTThe development of information and communication technology has circulated a lot of information about the patient's illness in the form of photos and videos on various social media. Media raises ethical issues, namely the violation of medical secrets. However, the Indonesian Medical Ethics Code (KODEKI) and Law No. 29 of 2004 concerning Medical Practice and other statutory regulations states that doctors are obliged to keep medical secrets. Based on this background, the research method in this writing uses juridical-normative research methods, namely research that emphasizes the use of legal norms in writing and is supported by the results of interviews with sources and informants. The type of research that used is prescriptive analysis, namely reviewing or reviewing the provisions of the legislation in the field of medicine and their implementation into an empirical framework or social order. Doctors and dentists are expected to use social media wisely by considering the ethical aspects contained in the Indonesian Medical Ethics Code (KODEKI) and the provisions of the laws and regulations in force in Indonesia. Thus, doctors must be able to account for their actions by: applying ethical sanctions, disciplinary sanctions and legal sanctions."

"Penelitian ini membahas kepatuhan dokter dalam pengisian formulir summary list di Instalasi Rawat Jalan, RSUP Fatmawati tahun 2015, yang merupakan penelitian kuantitatif dengan desain cross sectional dan menggunakan data primer dan data sekunder. Penelitian ini menghasilkan kepatuhan yang rendah, pendidikan terbanyak dokter spesialis, pengetahuan kurang baik, masa kerja yang seimbang, umur yang seimbang, persepsi sanksi kurang sesuai, persepsi insentif kurang sesuai, dan jumlah kunjungan yang sedikit. Terdapat dua variabel yang bermakna yaitu pendidikan dan sanksi, sementara variabel lain yaitu pengetahuan, umur, masa kerja, jumlah kunjungan, dan insentif menghasilkan hubungan yang tidak bermakna.

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This undergraduate thesis discusses about doctor compliance toward writing summary list form, in outpatient department, RSUP Fatmawati 2015. This research using cross sectional design with quantitative approach, and use both primary and secondary data.

The result of this research shows that doctor compliance are in a low rate, poorly knowledge, most of the education level are specialist, working periods are balance, ages are balance, inappropriate perception of sanction and insentives. There are two variables that have correlation, those are educational level and sanction. And the variables that have no correlation are knowledge, working period, and insentives."

"Indonesia masih mengalami kesulitan terkait akses masyarakat terhadap layanan kesehatan serta kurangnya tenaga kesehatan, terutama di wilayah perdesaan dan terpencil. Berdasarkan data Sistem Informasi Sumber Daya Manusia Kesehatan (SISDMK), terdapat kekurangan tenaga kesehatan, khususnya dokter, yang ditandai dengan masih banyaknya jumlah Puskesmas tanpa dokter. Provinsi Maluku adalah salah satu Provinsi yang memiliki persentase Puskesmas tanpa dokter tertinggi yaitu 17,6% dan Puskesmas tersebut mayoritas terletak di wilayah perdesaan dan terpencil yang ditetapkan oleh pemerintah. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan motivasi dokter untuk bekerja di daerah perdesaan dan terpencil di Provinsi Maluku. Desain penelitian ini adalah cross-sectional menggunakan kuesioner online yang disebarkan kepada 344 dokter yang bekerja di Provinsi Maluku. Hasil penelitian menunjukkan bahwa dari 192 (56%) dokter yang mengisi kuesioner, faktor pengalaman di perdesaan dan terpencil (p=0,032), peluang karir (p=0,000), peluang pengembangan pendidikan dan profesional (p=0,010) dan kondisi kehidupan (p=0,016) merupakan faktor-faktor yang berhubungan dengan motivasi dokter untuk bekerja di daerah perdesaan dan terpencil di Provinsi Maluku. Sementara faktor yang paling dominan berhubungan adalah peluang karir (AOR=4,32 95% CI 1,43-11,76 95% CI) dan pengalaman di perdesaan dan terpencil 1-5 tahun (AOR=4,30 95% CI 1,24-14,70 95% CI). Penelitian ini menunjukkan bahwa dalam membuat kebijakan untuk mengatasi kekurangan dokter di daerah perdesaan dan terpencil khususnya di Provinsi Maluku, pemerintah harus memberikan perhatian khusus terhadap peluang pengembangan pendidikan dan profesional, kondisi kehidupan, dan terutama kebijakan terkait peluang kemajuan karir dokter serta kebijakan yang menunjang dokter agar memiliki pengalaman praktik di perdesaan dan terpencil.

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Indonesia is still experiencing difficulties related to community access to health services and the need for more health workers, especially in rural and remote areas. Based on data from the Health Human Resources Information System (SISDMK), there is a shortage of health workers, especially doctors, as indicated by the large number of Public Health Centers that are without doctors.  Maluku Province is one of the provinces with the highest percentage of Public Health Centers without doctors, at 17.6%, and most of these are located in rural and remote areas designated by the government. This study aims to determine the factors that associated with doctors' motivation to work in rural and remote areas in Maluku Province. The design of this study was cross-sectional, using an online questionnaire distributed to 344 doctors working in Maluku Province. The results showed that of 192 (56%) partisipants who filled out the questionnaire, the factors of experience in rural and remote areas (p=0.032), career opportunities (p=0.000), educational and professional development opportunities (p=0.010), and living conditions (p=0.016) were factors associated with doctors' motivation to work in rural and remote areas in Maluku Province. While the most dominant factors associated are career opportunities (AOR = 4.32 95% CI 1.43-11.76 95% CI) and experience in rural and remote areas 1-5 years (AOR=4,30 95% CI 1,24-14,70 95% CI). This study suggests that in making policies to overcome the shortage of doctors in rural and remote areas, especially in Maluku Province, the government should consider the following factors such as educational and professional development opportunities, living conditions, and primarily policies related to opportunities for career advancement of doctors and policies that support doctors to have practice experience in rural and remote areas."

"The usage of phronesis as a term in the field of medicine aims at describing doctors as men of virtue. It is an obligation that they should put it into practice in their profession. In this article, I will present the idea standing behind the study and practice of medicine, that is, doctors or the candidates should have a holistic knowledge. One of those elements is that the field of medicine has a relation with other disciplines that work on the same material object, namely human beings. Other is that human beings are not machines -- which are unorganic, mindless and inactive. Avoiding mistreating course, assist doctors to be the men of virtue."

"Latar Belakang:Keterlambatan penanganan pasien STElevation Myocardial Infarction(STEMI)menjadi penyebab tingginya mortalitas dan kejadian MACE (Major Adverse Cardiac Events). Di Indonesia, pasien pasien STEMI sering mengalami keterlambatan penanganan. Upaya yang dapat dilakukan di fasilitas kesehatan dengan kemampuan Primary Percutaneous Coronary Intervention(PCI) adalah mencapai reperfusi tepat waktu pasien STEMI. Berbagai strategi dilakukan untuk mencapai reperfusi tepat waktu diantaranya dengan menerapkan program CODE STEMI. Program CODE STEMI merupakan notifikasi STEMI melalui sistem panggilan tunggal yang dapat mempercepat waktu reperfusi pasien STEMI di rumah sakit.Tujuan:Mengetahui pengaruh penerapan program CODE STEMI terhadap Door to Balloon Time (D2BT) dan MACE pasien STEMI yang menjalani PrimaryPCI di RSUPN Cipto Mangunkusumo Jakarta.Metode:Penelitian ini merupakan studi kohort retrospektif pada 255 rekam medis pasien STEMI yang menjalani PrimaryPCI di RSUPN Cipto Mangunkusumo sebelum penerapan program CODE STEMI (2015-2016) dan sesudah penerapan program CODE STEMI (2017-2018). Analisis data dilakukan secara kuantitatif dengan uji Mann whitney untuk D2BT dan chi square untuk MACE.Hasil:Terdapat 111 pasien pada kelompok Non CODE STEMI dan 144 pasien pada kelompok CODE STEMI. D2BT berkurang bermakna 110 menit dari 275 (99-2356) menit pada kelompok Non CODE STEMI menjadi 165 (67-1165) menit pada kelompok CODE STEMI (p <0.001). Kejadian MACE (48,4% vs 51,6%; p = 0,120), gagal jantung (46,6% vs 42 %; p = 0,288), syok kardiogenik (27% vs 19,4%; p = 0,152), aritmia (12,6% vs 6,2%; p = 0,079), stroke (4,5% vs 5,6%; p = 0,705) dan angka mortalitas (7,2% vs 3,5%; p = 0,179) sama antara kedua kelompok.Kejadian infark berulang dan PCI ulang berkurang bermakna pada kelompok CODE STEMI (4,5% vs 0,7%; p = 0.047, 2,7% vs 0,0%; p = 0.047).Simpulan:Program CODE STEMI memperbaiki D2BT. Program CODE STEMI tidak menurunkan kejadian MACE.

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Background: Delay in the management of ST Elevation Myocardial Infarction (STEMI)patients is a cause of high mortality and the incidence of Major Adverse Cardiac Events (MACE).In Indonesia, STEMI patients often experience delays in treatment. Efforts that can be made in health facilities with Primary PercutaneousCoronary Intervention(PCI)capability are achieving timely reperfusion of STEMI patients. Various strategies were carried out to achieve timely reperfusion including implementationthe CODE STEMI program. The CODE STEMI program is a STEMI notification through a single call system that can speed up the reperfusion time of STEMI patients in the hospital.

Objective:To determine the effect of the implementation of the CODE STEMI program on Door to Balloon Time (D2BT) and MACE of STEMI patients undergoing Primary PCI at Cipto Mangunkusumo National Central General Hospital Jakarta.

Methods: This was a retrospectivecohort study on 255 medical records of STEMI patients undergoing Primary PCI at Cipto Mangunkusumo National Central General Hospital before the application of the CODE STEMI program (2015-2016) and after the application of the CODE STEMI program (2017-2018). Data analysis was performed quantitatively by Mann Whitney test for D2BT and chi square for MACE

Results:There were 111 patients in the Non CODE STEMI group and 144 patients in the CODE STEMI group. D2BT decreased significantly 110 minutes from 275 (99-2356) minutes in the Non CODE STEMI group to 165 (67-1165) minutes in the CODE STEMI group (p <0.001). MACE events (48.4% vs 51.6%; p= 0.120), heart failure (46.6% vs 42%; p = 0.288), cardiogenic shock (27% vs 19.4%; p = 0.152), arrhythmia (12.6% vs 6.2%; p = 0.079), stroke (4.5% vs 5.6%; p = 0.705) and mortality rate (7.2% vs 3.5%; p = 0.179 ) were similar between the two groups. The incidence of reinfarction and repeated PCI was significantly reduced in the CODE STEMI group (4.5% vs 0.7%; p = 0.047, 2.7% vs 0.0%; p = 0.047).C

onclusions:The CODE STEMI program reduces D2BT. The CODE STEMI program did not reduce the overall MACE incidence but reduced the incidence of reinfarction and repeated PCI of STEMI patients undergoing Primary PCI at Cipto Mangunkusumo National Central General Hospital. "

"Acute Kidney Injury (AKI) merupakan komplikasi serius yang umum terjadi pada pasien rawat inap. Berdasarkan penelitian tahun 2005, terjadi peningkatan insiden dan keparahan AKI hingga 50% akibat penggunaan obat selama rawat inap. Salah satu tugas apoteker di RS adalah melakukan pemantauan terapi obat, terdapat beberapa obat di RSUI yang dinilai mampu menginduksi terjadinya AKI. Oleh karena itu, dilakukan pembuatan daftar obat yang dapat menginduksi terjadinya AKI serta studi kasus terjadinya AKI pada pasien rawat inap akibat penggunaan obat di RSUI pada bulan Maret 2023. Daftar obat penginduksi AKI dibuat berdasarkan studi literatur dari pustaka tahun 2005 – 2023 kemudian obat dikategorikan berdasarkan kelas terapi obat. Sedangkan, studi kasus dilaksanakan secara retrospektif menggunakan data sekunder pasien rawat inap RSUI pada bulan Maret 2023 yaitu rekam medis salah satu pasien yang memenuhi kriteria inklusi dan eksklusi. Terdapat 26 obat yang mampu menginduksi AKI di RSUI. Berdasarkan studi kasus, terapi ramipril diduga mampu meningkatkan risiko terjadinya AKI pada salah satu pasien RSUI yang dinilai berdasarkan peningkatan nilai serum kreatinin dan penurunan nilai GFR. Ramipril diduga menjadi penyebab peningkatan risiko terjadinya AKI berdasarkan angka prevalensinya sebesar 28%, adanya riwayat perbaikan fungsi ginjal saat penghentian obat, serta fungsi ginjal yang kembali memburuk ketika terapi ramipril kembali dilanjutkan. Penilaian kondisi pasien menggunakan instrumen naranjo dibutuhkan untuk mengonfirmasi insiden terjadinya AKI akibat ramipril.

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Acute Kidney Injury (AKI) was a serious complication that commonly occurs in inpatients. Based on a study in 2005, there was an increase in the incidence and severity of AKI up to 50% due to drug induce during hospitalization. One of the responsibilities of the pharmacist in the hospital was to perform drug therapy monitor and several drugs in RSUI were considered likely to induce AKI. Therefore, a list of drugs induced AKI was created, and a case study of drug-induced AKI in hospitalized patients at RSUI in March 2023 was performed. The list of drugs induced AKI was made based on a literature study from 2005 – 2023, then the drugs were categorized based on the drug therapy class. Meanwhile, the case study was carried out retrospectively using secondary data from hospitalized patients at RSUI in March 2023, which was the medical records from one of the patients who met the inclusion and exclusion criteria. There are 26 drugs-induced AKI in RSUI. Based on the case study, ramipril therapy was thought to be likely to increase the risk of developing AKI in one of the RSUI patients as assessed by the increase of creatinine serum and the decrease GFR values. Ramipril is thought to be the cause of the increased risk of AKI based on its prevalence rate which was 28%, history of improvement in kidney function when stopping the drug, and worsened kidney function when ramipril therapy is resumed. Assessment of the patient's condition using the Naranjo instrument is needed to confirm the incidence of AKI due to ramipril."

"Patient satisfaction was one thing that was very important in reviewing the quality of health services, including health center. Measuring patient satisfaction can be used to evaluate the quality of health services. In this study the dimensions related to health service user satisfaction, were in terms of reliability, assurance, tangible, emphaty and responsiveness. The purpose of this research was to know the level in district of outpatient services and inpatient care at district health center Sidoarjo."

"Skripsi ini membahas peran dokter militer dalam melaksanakan tugas Operasi Militer Selain Perang (OMSP), khususnya dalam memberikan bantuan bencana alam kepada masyarakat di Indonesia, serta menjelaskan pelindungan hukum yang diterima oleh dokter militer dalam melaksanakan tugas tersebut. Metode yang digunakan penelitian ini adalah doktrinal dengan tipe deskriptif analitis. Tulisan ini menjelaskan peran dan pelindungan hukum dokter militer dalam menjalankan tugas bantuan bencana alam di Indonesia. Penelitian ini menjelaskan bahwa dokter militer memiliki kompetensi dan kewenangan khusus yang menjadikan dokter militer menjadi garda terdepan dalam memberikan bantuan bencana alam kepada korban di Indonesia. Dalam melaksanakan tugasnya, dokter militer mendapatkan pelindungan hukum sebagai tenaga kesehatan yang memberikan pelayanan medis kepada masyarakat sebagaimana yang telah diatur dalam Undang-Undang Nomor 17 Tahun 2023 Tentang Kesehatan. Pelindungan hukum terhadap dokter militer dalam keadaan gawat darurat bencana yang membawa kondisi ke dalam gawat darurat medis tersebut meliputi ketiadaan informed consent, penulisan rekam medis, serta pemberian bantuan medis yang sesuai dengan Standar Operasional Prosedur (SOP), etika, dan disiplin. Namun, penelitian ini juga menemukan adanya permasalahan terkait ketidakjelasan alur dalam pemberian bantuan korban bencana dan belum adanya penegasan pelindungan hukum terhadap dokter militer, khususnya dalam memberikan bantuan korban bencana alam. Oleh karena itu, diperlukan koordinasi yang lebih baik antara TNI dan pihak terkait seperti BNPB untuk memperjelas alur koordinasi bantuan bencana alam, serta penegasan lebih lanjut oleh Kementerian Pertahanan dan Kementerian Kesehatan mengenai pelindungan hukum bagi dokter militer dalam melaksanakan tugas bantuan bencana alam.

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This thesis discusses the role of military doctors in carrying out the duties of Military Operations Other Than War (OMSP), especially in providing natural disaster assistance to the community in Indonesia, and explains the legal protection received by military doctors in carrying out these duties. The method used in this research is doctrinal with analytical descriptive type. This paper explains the role and legal protection of military doctors in carrying out natural disaster relief duties in Indonesia. This research explains that military doctors have special competencies and authorities that make military doctors the frontline in providing natural disaster relief to victims in Indonesia. In carrying out their duties, military doctors get legal protection as health workers who provide medical services to the community as regulated in Law Number 17 of 2023 concerning Health. Legal protection for military doctors in disaster emergencies that bring conditions into medical emergencies includes the absence of informed consent, writing medical records, and providing medical assistance in accordance with Standard Operating Procedures (SOPs), ethics, and discipline. However, this study also found problems related to the unclear flow in providing assistance to disaster victims and the absence of affirmation of legal protection for military doctors, especially in providing assistance to disaster victims."