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"Skripsi ini membahas mengenai kompetensi perawat ICU dan HCU yang diterapkan pada rumah sakit sesuai atau tidak dengan standar departemen kesehatan. Tujuan penelitian ini adalah untuk mengetahui gambaran kompetensi perawat ICU dan HCU serta Hubungannya dengan Pendidikan, Pelatihan dan Pengalaman. Pengumpulan data dengan form sebagai instrumen untuk melihat gambaran kompetensi sesuai standar atau tidak. Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross sectional. Hasil penelitian mengatakan bahwa kompetensi perawat yang memenuhi standar sebanyak 56 %. Untuk hubungan antara pelatihan dan kompetensi perawat didapat hasil p value = 0,001 yang artinya ada hubungan yang bermakna antara pelatihan dan kompetensi perawat Icu dan HCU. Hasil penelitian menyarankan untuk mengevaluasi lebih lanjut kompetensi perawat khususnya pada perawat intensif dan diharapkan pihak manajemen rumah sakit lebih banyak memberi pelatihan-pelatihan terhadap perawat baik yang telah bekerja lebih lama atau pekerja yang masih baru.

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This essay discusses the competency of the HCU and ICU nurses who applied to the hospital or not in accordance with health department standards. Goal of this research is to know the description of competency HCU and ICU nurses and the relationship with the Education, Training and Experience. Collecting data with the instrument as a form to view a description of competence according to standard or not. This research is a quantitative research with cross sectional approach. Said that the results of research nurses who meet the competency standards as much as 56%. For the relationship between training and competence of nurses obtained p value = 0.001 which means that no meaningful relationship between the training and competency HCU and ICU nurses. Results suggest that research to further evaluate the competency of nurses, especially nurses and intensive management expected the hospital to provide more training for both nurses who have worked longer or workers who are still new."

"Latar Belakang: Prevalensi infeksi yang disebabkan oleh multidrugs resistent microorganism (MDRO), terutama bakteri Enterobacteriaceae penghasil enzim extended-spectum beta-lactamase (ESBL) semakin meningkat. Identifikasi yang cepat dan pemberian antibiotik yang tepat, terutama untuk pasien intensive care unit (ICU), dibutuhkan untuk menurunkan lama rawat dan menurunkan angka mortalitas. Duke clinical score merupakan suatu instrumen stratifikasi risiko untuk memprediksi infeksi bakteri Enterobactericeae penghasil ESBL. Duke clinical score pernah diteliti untuk memprediksi infeksi yang didapat dari komunitas, namun belum pernah diteliti untuk pasien ICU.Metode: Penelitian ini merupakan uji diagnostik dengan design kohort prospektif. Subjek penelitian merupakan pasien ICU RSUPN Dr. Cipto Mangunkusumo (RSCM) yang memenuhi kriteria inklusi selama bulan Januari-Maret 2022. Skrining dengan swab rektum untuk melihat adanya infeksi bakteri Enterobacteriaceae penghasil enzim ESBL dilakukan dalam 24 jam pertama perawatan pasien di ICU. Kultur klinis dilakukan sesuai indikasi. Duke clinical score diperiksa pada awal perawatan pasien di ICU. Pasien yang tidak terinfeksi bakteri Enterobacteriaceae penghasil enzim ESBL di awal perawatan di ICU akan diobservasi dan diambil kembali swab rektum pada akhir perawatan di ICU. Penelitian akan menilai sensitivitas, spesifisitas, positive dan negative predictive value (PPV, NPV), area under curve (AUC) receiver operating characteristic (ROC) Duke clinical score.Hasil: Dari 105 pasien yang memenuhi kriteria inklusi, 55% pasien memiliki swab rektum atau kultur klinis yang positif dengan bakteri Enterobacteriaceae penghasil enzim ESBL dalam 24 jam perawatan pertama di ICU sehingga dieksklusi. Total subjek penelitian 47 pasien yang tidak terinfeksi bakteri Enterobacteriaceae penghasil ESBL pada awal perawatan di ICU. Pada nilai cut-off ≥ 8.5, Duke clinical score memiliki sensitivitas 32%, spesifisitas 89%, PPV 67%, NPV 66%. AUC ROC 0.652.Kesimpulan: Duke clinical score tidak valid sebagai prediktor infeksi bakteri Enterobacteriaceae penghasil enzim ESBL pada pasien ICU RSCM....... Background: The prevalence of infections caused by multidrugs resistant microorganisms, especially extended-spectrum-beta-lactamase (ESBL)-producing Enterobacteriaceae, is increasing. Rapid identification and proper administration of antibiotics, especially for intensive care unit (ICU) patients, are needed to reduce length of stay and lower mortality rates. Duke clinical score is a risk stratification instrument for predicting infection caused by ESBL-producing Enterobactericeae. Duke clinical scores have been studied to predict community-acquired infections, but have never been studied for ICU patients.Methods: This study was a diagnostic test with a prospective cohort design. The subjects were patients of ICU Cipto Mangunkusumo general teaching hospital (RSCM) during January-March 2022 who met the inclusion criterias. Screening with a rectal swab to see the presence of infection with the ESBL-producing Enterobacteriaceae was carried out within the first 24 hours of admission in ICU. Clinical culture was carried out according to indications. Duke clinical score was examined at the beginning of the patient's treatment in the ICU. Patients who were not infected with the ESBL-producing Enterobacteriaceae at the beginning of treatment in the ICU would be observed and rectal swab would be taken at the end of treatment in the ICU. The study would assess the sensitivity, specificity, positive and negative predictive value (PPV, NPV), area under curve (AUC) receiver operating characteristic (ROC) Duke clinical score.Results: Of the 105 patients who met the inclusion criteria, 55% of them had a positive rectal swab and/or clinical cultures with ESBL-producing Enterobacteriaceae within the first 24 hours of treatment in the ICU. A total of 47 subjects were identified as patients who were not infected with ESBL-producing Enterobacteriaceae at the beginning of treatment in the ICU. At a cut-off value ≥ 8.5, Duke clinical score have sensitivity 32%, specificity of 89%, PPV of 67%, NPV of 66%. AUC ROC 0.652.Conclusions: Duke clinical score is invalid as a predictor of ESBL-producing Enterobacteriaceae infection in ICU RSCM patients."

"Latar belakang. Saat pandemi COVID-19 terjadi, penderita asma dianggap memiliki peningkatan risiko infeksi terhadap COVID-19. Timbul pertanyaan apakah persiapan khusus terhadap kondisi klinis yang berat mungkin dibutuhkan bagi pekerja di lokasi terpencil. Objektif. Studi ini berusaha menjawab apakah terdapat peningkatan risiko perawatan intensif (Intensive Care Unit/ ICU) pada pekerja dengan COVID-19 yang memiliki riwayat asma. Metode. Pencarian literatur dilakukan melalui database PubMed, Scopus dan ProQuest, serta pencarian manual. Kriteria inklusi adalah tinjauan sistematis, studi kohort, studi retrospektif, studi cross sectional, COVID-19, asma, dan ICU. Kemudian dilakukan telaah kritis terhadap lietratur berdasarkan Center of Evidence-Based Medicine, Oxford University, Critical Appraisal for Prognostic Studies and Systematic Reviews. Hasil. Tiga studi tinjauan sistematis dan tiga studi kohort retrospektif ditemukan. Tinjauan sistematis oleh Sunjaya, et al. (2021) dan Husein, dkk. (2021), serta studi kohort retrospektif oleh Calmes, MD, et al. (2021) menunjukkan tidak ada perbedaan yang signifikan pada risiko perawatan di ICU untuk penderita asma dibandingkan non-asma (RR 1.19; CI 95%: 0.93 – 1.53; p= 0.16), (RR= 1.64, 95%CI = 0.67-3.97; p=0,27), dan (OR = 1,4 (95% CI = 0,64-3,2); p = 0,39). Tinjauan sistematis oleh Liu (2021), menunjukkan tidak ada perbedaan yang signifikan dalam prevalensi asma antara pasien ICU dan non-ICU (RR, 1,19; 95% CI, 0,92-1,54; P = 0,17; I2 = 48,6%;). Studi kohort oleh Choi, et al (2020) menunjukkan bahwa asma bukan merupakan faktor prediktif masuknya ICU pada pasien COVID-19 (OR 0,656 (95%CI= 0,295 – 1,440); nilai p =0,302). Sebaliknya, studi kohort oleh Jin, MMed, et.al (2020) menunjukkan bahwa pasien COVID-19 dengan asma memiliki proporsi masuk ICU yang lebih tinggi daripada mereka yang tidak. Kesimpulan. Pekerja COVID-19 dengan asma tidak memiliki risiko masuk ICU yang lebih tinggi.......Background. As the COVID-19 pandemic occurs, those with asthma were thought to have an increased risk of infection. Question arisen whether special preparation for severe clinical outcomes might be needed for remote site workers. Objective. The study sought to answer whether an increased risk of an ICU admission for COVID-19 patients among workers who have a history of asthma exist. Method. A literature search was conducted through PubMed, Scopus and ProQuest databases, as well as hand searched. The inclusion criteria were systematic review, cohort study, retrospective study, cross sectional study, COVID-19, asthma, and ICU. Then, they were critically appraised based on Center of Evidence-Based Medicine, Oxford University, Critical Appraisal for Prognostic Studies and Systematic Reviews. Result. Three systematic review studies and three retrospective cohort studies were found. Systematic reviews by Sunjaya, et al. (2021) and Hussein, et al. (2021), also retrospective cohort study by Calmes, MD, et al. (2021) showed no significant difference in risk requiring admission to ICU for asthmatic compared to non-asthmatic (RR 1.19; CI 95%: 0.93 – 1.53; p= 0.16), (RR= 1.64, 95%CI = 0.67-3.97; p=0.27), and (OR = 1.4 (95% CI = 0.64-3.2); p =0.39), respectively. Systematic review by Liu (2021), showed no significant difference in asthma prevalence between ICU and non-ICU patients (RR, 1.19; 95% CI, 0.92-1.54; P =0 .17; I2 = 48.6%;). Cohort study by Choi, et al (2020) showed asthma was not a predictive factor for ICU admission in COVID-19 patients (OR 0.656 (95%CI= 0.295 – 1.440); p value =0.302). Contrary, cohort study by Jin, MMed, et.al (2020) showed that COVID-19 patients with asthma had a higher proportion of ICU admission than those who do not have. Conclusion. COVID-19 workers with asthma does not have a higher risk of ICU admission."

"Latar Belakang: Tenaga kesehatan (nakes) menjadi garda terdepan dalam pelayanan kesehatan di saat pandemi COVID-19. Tidak hanya dokter, perawat atau bidan dan nakes penunjang seperti petugas radiologi rentan untuk risiko terinfeksi COVID-19. Zona kerja nakes merupakan salah satu faktor yang berpengaruh terhadap risiko terinfeksi COVID-19. Penelitian ini bertujuan untuk mengetahui faktor risiko kejadian COVID-19 pada nakes yang bekerja di perawatan isolasi COVID-19.Metode Penelitian: Penelitian ini merupakan studi potong lintang dengan metode total sampling pada tenaga kesehatan yang bekerja di ruang rawat inap isolasi COVID-19 periode Maret sampai Desember 2020. Respons kuesioner penelitian elektronik yang disebarkan akan ditabulasi dan dianalisis.Hasil Penelitian: Subjek penelitian yang memenuhi kriteria inklusi sebanyak 292 orang dengan mayoritas berusia ≥30 tahun (75,7%), profesi nondokter (91,8%), bekerja di zona kerja non-ICU (70,2%) dan hasil PCR COVID-19 negatif (64%). Zona kerja non-ICU, jenis kelamin, kekerapan kadang-kadang, jarang dan tidak pernah dalam penggunaan APD level 3 serta pelatihan PPI dari RS dalam hal standar APD era pandemi bermakna meningkatkan peluang risiko kejadian COVID-19. Sedangkan, kepatuhan protokol kesehatan dalam hal kontak erat dengan selain orang serumah, salah satu tidak memakai masker dan lama kontak >15 menit, pemasangan kanula hidung dan kontak dengan kolega positif COVID-19 bermakna menurunkan peluang risiko kejadian COVID-19....... k Berbahasa Inggris: Background: : Health workers are at the forefront of health services during the COVID-19 pandemic. Not only doctors, nurses or midwives and supporting health workers such as radiology officers are vulnerable to being infected with COVID-19. The health worker's work zone is one of the factors that influences the risk of contracting COVID-19. This study aims to determine the risk factors for the occurrence of COVID-19 in health workers who work in isolation care for COVID-19.Methods: This research is a cross-sectional study using total sampling method on healthcare workers who work in the COVID-19 isolation ward from March to December 2020. The responses of the distributed electronic research questionnaire will be tabulated and analyzed.Results: There were 292 subjects who met the inclusion criteria with the majority aged ≥30 years (75.7%), non-doctors (91.8%), working in non-ICU work zones (70.2%) and negative COVID-19 PCR results (64%). Non-ICU working zone, gender, frequency of sometimes, rarely and never in the use of level 3 PPE as well as PPI training from hospitals in terms of PPE standards in the pandemic era significantly increased the risk of COVID-19 incident. Meanwhile, adherence to health protocols in terms of close contact with other than people in the household, one of them does not wear a mask and the duration of contact is >15 minutes, installation of nasal cannulae and contact with positive COVID-19 colleagues significantly reduced the COVID-19 incident."

"Perawat di unit perawatan intensif memiliki beban kerja yang tinggi, yang dapat menjadi sumber stres kerja bagi perawat ICU. Penelitian deskriptif ini bertujuan untuk mengidentifikasi tingkat stres kerja yang dialami perawat di ICU RS. Kanker Dharmais. Sampel pada penelitian ini adalah total populasi yaitu sebanyak 33 responden. Penelitian ini menunjukkan bahwa 22 orang (66.7%) perawat di ruang ICU mengalami tingkat stres kerja sedang. Peneliti merekomendasikan untuk dilakukan penelitian lanjutan tentang faktor-faktor stres kerja atau hubungan karakteristik responden dengan tingkat stres kerja. Penelitian ini bermanfaat sebagai sumber masukan untuk strategi menurunkan stres kerja atau manajemen stres pada perawat di ICU. ......Nurses in the intensive care unit have a high workload, which can lead a work stress for them. This descriptive study aims to identify the level of work stress of nurses in ICU Dharmais Cancer Hospital. Data were collected from total sampling of 33 nurses. Study showed that 22 (66.7%) nurses in the ICU had moderate work stress levels. Some recommendation of this study were proposed that future research could be identify factors related to work stress level. The result of this study would be beneficial to develop the stress management among ICU nurses."

"Pasien di ruang intensif selain mengalami masalah biologis juga mengalami masalah psikologis seperti kecemasan. Kecemasan yang tidak terkontrol dapat mempengaruhi hemodinamik serta mengganggu proses perawatan. Terapi non-farmakologis dapat menjadi pilihan untuk mengatasi kecemasan. Penelitian ini bertujuan untuk mengetahui pengaruh intervensi keperawatan KoMoYas terhadap tingkat kecemasan pasien pasca operasi di ruang intensif. Penelitian ini menggunakan quasy experimental study. Metode sampling dengan consecutive sampling sebanyak 29 responden kelompok intervensi dan 29 responden kelompok kontrol. Hasil penelitian dengan uji Wilcoxon menunjukkan adanya penurunan tingkat kecemasan pre dan post-test baik pada kelompok intervensi maupun pada kelompok kontrol dengan nilai p-value 0.000 (< 0.05). Penurunan nilai kecemasan terjadi lebih banyak pada responden kelompok intervensi dibandingkan dengan kelompok kontrol, ditandai dengan selisih nilai mean (pre dan post) pada kelompok intervensi sebesar 1.31 dan pada kelompok kontrol selisih nilai mean (pre dan post) sebesar 0.45. Uji Mann Whitney dilakukan dengan hasil p value=0.000 (< 0.05), sehingga disimpulkan terdapat perbedaan rerata kecemasan pre-test dan post-test antara kelompok intervensi dengan kelompok kontrol. Intervensi KoMoYas dikombinasikan dengan terapi non farmakologis lainnya dapat dengan signifikan menurunkan tingkat kecemasan......n addition to experiencing biological problems, patients in the intensive care unit also experience psychological problems such as anxiety. Uncontrolled anxiety can affect hemodynamics and interfere with the treatment process. Non-pharmacological therapy can be an option for dealing with anxiety. This study aims to determine the effect of KoMoYas nursing interventions on the anxiety level of postoperative patients in the intensive care unit. This research uses a quasy experimental study. The sampling method with consecutive sampling consisted of 29 respondents in the intervention group and 29 respondents in the control group. The results of the study with the Wilcoxon test showed a decrease in pre- and post-test anxiety levels in both the intervention group and the control group with a p-value of 0.000 (<0.05). The decrease in anxiety scores occurred more in respondents in the intervention group than in the control group, marked by a difference in the mean value (pre and post) in the intervention group of 1.31 and in the control group the difference in mean value (pre and post) was 0.45. The Mann Whitney test was carried out with a p value = 0.000 (<0.05), so it was concluded that there was a difference in the mean pre-test and post-test anxiety between the intervention group and the control group. KoMoYas intervention combined with other non-pharmacological therapies can significantly reduce anxiety levels."

"Antibiotika golongan sefalsoporin merupakan salah satu antibiotika yang banyak digunakan oleh pasien ICU RSUP Fatmawati Jakarta. Tujuan dari penelitian ini adalah untuk mengetahui dan mengevalusi penggunaan antibiotika golongan sefalosporin pada pasien ICU. Penelitian ini dilakukan dengan metode survey yang bersifat deskriptif analitis retrospektif-prospektif. Data dikumpulkan dari Catatan Medis dan hasil pemeriksaan laboratorium (uji kultur dan sensitivitas) pasien ICU yang dirawat pada bulan Januari-September 2006.Hasil penelitian ini menunjukkan 323 pasien ICU (68,43%) menggunakan antibiotika golongan sefalosporin. Antibiotika golongan sefalosporin yang banyak digunakan adalah seftazidim 32,68%, seftriakson 29,05% dan sefpirom 14,50%. Pada evaluasi penggunaan antibiotika golongan sefalosporin terdapat 17,96% ketidaktepatan dosis.Hasil uji kultur dan sensitivitas menunjukkan bahwa antibiotika golongan sefalosporin telah mengalami resistensi yaitu sefaleksin (73,24%), sefotiam (71,83%), sefotaksim (63,38%), seftriakson (60,56%) dan sefpirom (60,34%). Data diuji dengan metode kai Kuadrat dan hasil yang diperoleh menunjukkan ada hubungan bermakna antara tingkat penggunaan antibiotika golongan sefalosporin dengan resistensi kuman terhadap antibiotika golongan sefalosporin di ICU RSUP Fatmawati.Cephalosporin is the most frequently antibiotics used at Intensive Care Unit, Fatmawati Hospital Jakarta. The objective of this study is to know the description and to evaluate the cephalosporin use at Intensive Care Unit. The study conducted with analytical descriptive retrospective-prospective method. The data collected from Medical Record and laboratory test result (Culture and Sensitivity Test) of ICU patient during January until September 2006.

The result of this study indicated that 323 patient (68,43%) used cephalosporin. The most frequently cephalosporin used by ICU patient was ceftazidime 32,68%, followed by ceftriaxone 29,05% and cefpirome 14,50%. Evaluation of cephalosporin used indicated 17,96 % an incorrect doses of cephalosporin.

The result of Culture and Sensitivity Test showed that cephalosporin has been resistance including cefotiam (71,83%), cefotaxime (63,38%), ceftriaxone (60,56%) and cefpirome (60,34%). The data from the study examined with Chi Square Test Method and the result show that there was a correlation between the level of cephalosporin use and the resistance of microbe to cephalosporin at Intensive Care Unit, Hospital Jakarta."

"Delirium yang terjadi di ICU dapat berdampak pada peningkatan angka morbiditas, penurunan fungsi tubuh, dan peningkatan masa rawat inap pasien di ICU. Perawat sebagai tenaga kesehatan perlu memiliki pengetahuan yang memadai terkait delirium di ICU. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan tingkat pengetahuan perawat intensif terhadap Delirium di ICU. Penelitian ini merupakan penelitian kuantitatif deskriptif dengan pendekatan cross sectional. Penelitian dilakukan pada 70 perawat intensif di RSUP Dr. M. Djamil Padang berdasarkan teknik pemilihan total sampling. Hasil penelitian menunjukkan mayoritas responden berpengetahuan tinggi 76%. Analisis chi square karakteristik perawat yang meliputi usia, jenis kelamin, tingkat pendidikan, masa kerja dan pelatihan ICU menunjukkan hasil yang tidak signifikan dengan pengetahuan perawat intensif tentang Delirium di ICU dengan p value > 0,05. Hasil penelitian ini merekomendasikan untuk tetap meningkatkan dan mempertahankan pengetahuan perawat terhadap Delirium di ICU agar terciptanya asuhan keperawatan yang baik.......Delirium that occurs in ICU can impact the increase of morbidity rate, decreased body function, and increase of patient’s hospitalization period in ICU. Nurse, as a health workers, requires to have adequate knowledge related to delirium in ICU. Therefore, this study aims to find out factors relate to knowledge level of intensive nurses to delirium in ICU. This study was descriptive quantitative with a cross-sectional approach. This study was conducted on 70 intensive nurses in RSUP Dr. M. Djamil Padang according to the total sampling technique. The results of the study show that the respondents have high knowledge 76%. Chi-Square analysis characteristic of nurse including age, gender, educational level, years of service shows there is no significant relationship to knowledge level of intensive nurses to ICU delirium with p value > 0,05. The results of the study recommend constantly improving and maintaining the knowledge of nurses to ICU delirium so that good nursing care can be created"