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"ABSTRAKTujuan : Untuk mengetahui pengaruh resistensi metisilin Staphylococcus aureus terhadap probabilitas ketahanan hidup 1 bulan pasien infeksi Staphylococcus aureus dan penilaian variabel lain yang mempengaruhi hubungan tersebut di ruang rawat inap di rumah sakit Cipto Mangunkusumo (RSCM) Jakarta.Desain : Kohort retrospektif dengan análisis survival menggunakan data sekunder dari catatan rekam medis pasien infeksi S.aureus tahun 2010-2015.Hasil : Dari total sampel 89 , 42 (47,19%) karena MSSA dan 47 (52,81%) karena MRSA. Probabilitas ketahanan hidup secara keseluruhan pasien infeksi S.aureus adalah 86%. Pada análisis bivariat diketahui bahwa resistensi metisilin S.aureus berhubungan dengan ketahanan hidup 1 bulan pasien infeksi S.aureus dengan hazard ratio 4,86 (95% CI : 1,06 ? 22,18). Tetapi setelah dilakukan análisis multivariat maka hubungan resistensi metisilin S.aureus dan ketahanan hidup dengan mengontrol variabel jenis kelamin dan hemodiálisis didapatkan hazard ratio 2,92 (95 % CI ; 0,59 - 14,44).Kesimpulan : Setelah memperhitungkan variabel jenis kelamin dan hemodialisis, penderita S.aureus yang resisten terhadap metisilin memiliki risiko kematian 2,92 kali (95 % CI ; 0,59 - 14,44) dibandingkan penderita S.aureus yang sensitif terhadap metisilin. Akan tetapi secara statistik hubungan ini tidak bermakna.

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ABSTRACTObjective : To identify the impact of methicillin resistance on 1?month survival rate in patients with Staphylococcus aureus infection and to evaluate of other variables, which affect the relationship between methicillin resistance and patient survival at Cipto Mangunkusumo (RSCM) hospital Jakarta.Design : Retrospective cohort with survival analysis between January 2010 and January 2015. The inclusion criteria were all patients with dm gangren, cellulitis,endocarditis, sepsis, osteomyelitis,burn wound infection and pneumonia. Data was collected from the medical records.Results : A total of 89 patients with S.aureus infection were included. Of these, 42 (47,19 %) had MSSA and 47 ( 52,81 %) had MRSA. Overall patients survival rate was 86%. By bivariate analysis, methicillin resistance associated with 1-month survival in patients with S.aureus infection (HR 4,86 ; 95% CI : 1,06 ? 22,18) . After adjusted or sex and hemodyalisis, MRSA infection was not found as an independent risk factor for 1-month survival (HR 2,92 ; 95 % CI ; 0,59 - 14,44).Conclusions : Patients with MRSA infections have a higher hazard rate than MSSA infections after adjusted for sex and hemodialysis (HR 2,92 ; 95 % CI ; 0,59 - 14,44), although MRSA infections was not found significantly associated with patients survival."

"Unit pelayanan rawat jalan merupakan bagian strategis dari suatu rumah sakit. Penampilan rumah sakit juga mencerminkan citra rumah sakit, sehingga keberhasilan pelayanan yang memenuhi tuntutan pasien sangat menentukan. Beberapa faktor penting yang menentukan adalah kelancaran alur pasien pada pelayanan rawat jalan. Hal ini dapat dicapai dengan memperhatikan penatalaksanaan baik bangunan fisik rawat jalan, maupun tenaga pelaksananya. Tujuan dari penelitian ini adalah untuk memperoleh gambaran yang jelas dan benar mengenai upaya-upaya yang dapat dilakukan dalam rangka meningkatkan mutu pelayanan rawat jalan, dengan mengetahui analisa situasi, tatalaksana, serta mengidentifikasi permasalahan akhirnya mengembangkan usulan peningkatan efektifitas alur pasien rawat jalan. Penelitian ini merupakan penelitian studi kasus dengan pendekatan pemecahan selain dikarenakan tataletak bangunannya, juga karena kapasitas ruang yang tersedia kurang memadai. Dengan melakukan wawancara pada petugas pelayanan rawat jalan, maka diketahui permasalahan yang ada di masing-masing unit, serta usulan pemecahan masalahnya. Dihubungkan dengan kepustakaan yang ada serta keinginan para pelaksana rawat jalan, maka dikembangkan usulan tataletak bangunan fasilitas rawat jalan dan diharapkan alur pasien yang terjadi menjadi lebih efektif.

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Outpatient Department is one of the strategic units in a hospital, because its performance become one indicator of hospital performances and also acts a show window of the hospital. Several factors affecting Outpatient Department's effectiveness i.e. flow of outpatient services, design of outpatient facilities, and knowledge and skill of their personnel's.

The objective of this study is to develop a framework to improve the outpatient department services in Sumedang General Hospital. To achieve this objective, the researcher did three activities, i.e. mapping the design of outpatient facilities, charting the flow of outpatient services from the time of patient's arrival to their departure in all clinics; and finally interviewing personals at the outpatient department. Design of this study is a case study in one hospital utilizing a problem solving approach activities.

Result of the situational analysis showed that the design of outpatient facilities in Sumedang Hospital had an impact on the effectiveness of patent services. Using a hypothetical flow of services from patient from intemaland surgery units, the study shown a crisscrossing pattern and the accumulation of crowd In the waiting area. Interview of the outpatient personnel's shown that many problems had not been treated properly in the past, and several solutions was proposed by the outpatient personnel's.

A new design of the outpatient facilities is proposed to reduce the crowding of patients in the waiting area, and improved the effectiveness of patent services in the outpatient department."

"Standar Akreditasi Rumah Sakit merupakan penilaian sejauh mana rumah sakit sudah melaksanakan program keselamatan pasien sesuai dengan Peraturan Menteri Kesehatan Nomor 1691 Tahun 2011. Rumah Sakit X belum sepenuhnya melaksanakan pelayanan berbasis keselamatan pasien. Penelitian deskriptif dengan metode kuantitatif dilanjutkan metode kualitatif bertujuan melihat persiapan Rumah Sakit X dalam menghadapai Akreditasi Bidang Keselamatan Pasien tahun 2016. Pada penelitian ini dihasilkan kuesioner keselamatan pasien berdasarkan Standar Akreditasi Rumah Sakit 2012. Uji Reliabilitas menghasilkan 65 pernyataan kuesioner menjadi 47 pernyataan kuesioner. Hasil penelitian didapatkan 17 komponen penilaian dari Standar Akreditasi Rumah Sakit 2012 masih harus ditingkatkan pelaksanaannya di Rumah Sakit X.

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Hospital Accreditation Standards is an assessment for hospitals to implement patient safety programs in accordance with the Regulation of the Minister of Health No. 1691 of 2011. Hospital X wasnot yet fully implementing patient safety based on the Hospital Accreditation 2012.

Descriptive research with quantitative method continued by qualitative method was implemented to study the preparation of Hospital X which will undergo Accreditation in 2016.

The research also developed questionnaire on Patient Safety based on The Hospital Accreditation 2012. Reliability test was done with the result of that 47 out of 65 questionnaires were reliable. The research found 17 points of The Hospital Accreditation 2012 still need improvement in implementation at Hospital X."

"Sistem rujuk keluar ditujukan ke rumah sakit lain diwajibkan bagi pasien dengan kondisi darurat dan stabil, setelah di rekomendasikan oleh dokter. Penelitian ini bertujuan untuk menganalisis faktor yang menyebabkan ketidaklengkapan pengisian formulir rujuk keluar di RSUP Fatmawati tahun 2017. Pengumpulan data studi observasional dengan pendekatan kualitatif dan kuantitatif ini dilakukan secara retrospektif. Hasil penelitian menunjukkan bahwa faktor yang berhubungan dengan kepatuhan dokter dalam mengisi formulir rujuk keluar rumah sakit adalah faktor pengetahuan dokter, beban kerja dokter, ketersediaan SOP, faktor pengawasan dan sistem penghargan dan sanksi. Sesuai SOP keterlibatan perawat dapat membantu pengisian formulir rujuk keluar.

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Referral systems transferring patient from one hospital to the other hospital has been set up and using a special form to be filled out by assigned doctor. This study aims to analyze the factors related to the completion of the form filled out by the doctors in Fatmawati Hospital. This observational study was done using qualitative and quantitative approach.

The study revealed that factors related to physician compliance to fill out the form were knowledge of physician on the importance of the completeness of the form, workload, no standard procedure, no systematic monitoring process. According to the procedure, the nurse is expected to help in completing the form."

"Latar belakang: Sejak adanya program Jaminan Kesehatan Nasional (JKN), persaingan bisnis di industri kesehatan semakin ketat akibat bertambahnya jumlah rumah sakit. Persentase angka kunjungan pasien eksekutif rawat jalan RS Hermina Bekasi yang stagnan dalam tiga tahun terakhir juga membuat manajemen harus mencari cara untuk meningkatkan profitabilitas. Mempertahankan pasien lama agar tetap loyal akan jauh lebih mudah dan murah untuk menghasilkan pemasukan bagi rumah sakit. Penelitian bertujuan untuk melihat gambaran loyalitas pasien eksekutif di instalasi rawat jalan RS Hermina Bekasi terhadap persepsi pasien tentang switching barriers ke rumah sakit pesaing dan faktor lain yang mempengaruhi sebagai dasar pembuatan strategi bisnis. Subyek dan metode: Metode penelitian kuantitatif dengan pendekatan cross sectional terhadap 150 pasien eksekutif rawat jalan RS Hermina Bekasi. Analisis dilakukan dengan uji univariat, bivariat, dan multivariat. Hasil: Uji multivariat menunjukkan bahwa terdapat dua variabel yang bernilai signifikan, yaitu switching barriers baru (p value = 0.14; Exp. (B) = 14.778) dan responsiveness (p value = 0.37; Exp. (B) = 11.083). Kesimpulan: Switching barriers menjadi variabel paling berpengaruh terhadap perilaku loyal di instalasi rawat jalan RS Hermina Bekasi sehingga strategi bisnis yang mempengaruhi switching barriers dapat diterapkan di rumah sakit.

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Background: Since the National Health Insurance (JKN) implemented, business competition in the health industry has increased due to the increasing number of hospitals. The percentage of outpatient executive visit numbers of Hermina Bekasi Hospital has been stagnant in the last three years also makes management have to find ways to increase profitability. Maintaining old patients to remain loyal has been easier and cheaper to generate revenue for the hospital. This study aims to analyze the patients perspective on the effect of switching barriers and other influencing factors towards loyalty among executive patients in the outpatient clinics of Hermina Bekasi Hospital in 2019 as the basis for creating business strategies.

Subjects and Methods: This research is a quantitative method with a cross-sectional approach to 150 outpatient executive clinics at Hermina Bekasi Hospital. Analyzes performed with univariate, bivariate, and multivariate tests.

Result: Multivariate test showed that there were two significant variables, namely new switching barriers (p value = 0.14; Exp. (B) = 14.778) and responsiveness (p value = 0.37; Exp. (B) = 11.083).

Conclusion: Switching barriers is the most influential variable on loyal behavior in the outpatient clinics of Hermina Bekasi Hospital. The switching barriers strategies have to implemented to achieve the hospital goals."

"Keselamatan adalah isu fundamental bagi rumah sakit, dimana keselamatan pasien merupakan prioritas utama karena berkaitan dengan kualitas dan nama baik rumah sakit. Pelaksanaan keselamatan pasien di rumah sakit dipengaruhi oleh berbagai faktor, antara lain faktor individu, faktor psikologis dan faktor organisasi. Pada tahun 2021, RSIA Bina Medika telah melakukan pengukuran budaya keselamatan pasien dimana diketahui bahwa budaya keselamatan pasien di RSIA Bina Medika masih tergolong rendah. Selain itu, pada tahun 2021 tercatat telah terjadi 37 insiden keselamatan pasien di RSIA Bina Medika, dimana tercatat telah terjadi 1 kejadian sentinel. Oleh sebab itu, penelitian ini dilakukan untuk mengetahui gambaran penerapan keselamatan pasien di RSIA Bina Medika pada tingkat individu dengan melakukan tela’ah dokumen Ongoing Professional Practice Evaluation (OPPE). Penelitian ini juga dilakukan untuk mengetahui gambaran sikap petugas terhadap keselamatan pasien dan hubungannya, serta gambaran pengetahuan petugas terhadap keselamatan pasien dan hubungannya. Selain itu, penelitian ini dilakukan untuk menemukan strategi yang tepat yang harus dilakukan manajemen rumah sakit dalam rangka meningkatkan keselamatan pasien di RSIA Bina Medika. Penelitian ini adalah penelitian mix method dengan pendekatan cross-sectional, dimana dilakukan survei kuesioner terkait sikap (dengan SAQ-INA) dan pengetahuan, serta wawancara mendalam, Focus Group Discussion (FGD) dan tela’ah dokumen terkait termasuk OPPE bagian Keperawatan tahun 2021. Dari hasil penelitian diketahui bahwa 54% petugas menerapkan keselamatan pasien dengan baik. Lalu, diketahui bahwa 56% petugas bersikap negatif terhadap keselamatan pasien dan 78% petugas berpengetahuan baik. Tidak ada hubungan yang signifikan antara sikap petugas dengan keselamatan pasien, begitu pula pengetahuan (p =1 dan p=0,08). Dari wawancara mendalam diketahui terdapat beberapa kendala dalam pelaksanaan keselamatan pasien di RSIA Bina Medika. Dari FGD didapatkan berbagai strategi peningkatan keselamatan pasien di RSIA Bina Medika yang akan diterapkan kedepannya. Dari keseluruhan penelitian ini diketahui bahwa penerapan keselamatan pasien di RSIA Bina Medika masih belum baik karena terdapat beberapa kendala dalam pelaksanaan keselamatan pasien di RSIA Bina Medika. Mayoritas petugas sudah berpengetahuan baik, namun masih banyak petugas yang bersikap negatif terhadap keselamatan pasien. Selain sikap dan pengetahuan, diketahui banyak faktor lainnya yang juga turut berkontribusi dalam pelaksanaan keselamatan pasien di RSIA Bina Medika.

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Safety is a fundamental issue for hospitals, where patient safety is a top priority because it relates to hospital’s quality and reputation. The implementation of patient safety in hospitals is influenced by various factors, such as individual factor, psychological factor and organizational factor. In 2021, RSIA Bina Medika had measured patient safety culture where the result showed that patient safety culture at RSIA Bina Medika was still relatively low. In addition, in 2021 there was 37 patient safety incidents at RSIA Bina Medika, where 1 sentinel incident had been recorded. Therefore, this research was conducted to find out the description of the implementation of patient safety at RSIA Bina Medika at individual level by conducting a review of the Ongoing Professional Practice Evaluation (OPPE) document. This study was also conducted to describe staff’s attitude towards patient safety and its relationship, as well as an overview of the staff's knowledge of patient safety and its relationship. In addition, this research was conducted to find the right strategy that hospital management must implement in order to improve patient safety at RSIA Bina Medika. This research was a mixed method research with a cross-sectional approach, in which a questionnaire survey was carried out regarding attitudes (with SAQINA) and knowledge, as well as in-depth interviews, Focus Group Discussion (FGD) and a review of related documents including the 2021 OPPE of Nursing section. The research results showed that 54% of staff implement patient safety well. Then, it was known that 56% of staff had a negative attitude towards patient safety and 78% of staff had good knowledge. There was no significant relationship between staff’s attitudes and patient safety, as well as knowledge (p = 1 and p = 0.08). From in-depth interviews it was known that there were several obstacles in implementing patient safety at RSIA Bina Medika. From the FGD, various strategies were obtained to improve patient safety at RSIA Bina Medika which will be implemented in the future. From all of this research it was known that the implementation of patient safety at RSIA Bina Medika was still not good because there were several obstacles in implementing patient safety at RSIA Bina Medika. The majority of staffs had good knowledge, but there were still many staffs who had negative attitude towards patient safety. Apart from attitude and knowledge, it was known that there were many other factors that also contribute to the implementation of patient safety at RSIA Bina Medika"

"Keselamatan pasien di rumah sakit masih menjadi isu krusial yang mendunia, karena rumah sakit merupakan institusi jasa pelayanan yang mengupayakan kesembuhan pasien. Maka keselamatan pasien menjadi suatu keniscayaan, diharapkan tidak terjadi insiden keselamatan pasien (zero insiden). Salah satu cara untuk mengendalikan peningkatan angka insiden di rumah sakit adalah dengan memanfaatkan sistem pelaporan. Penelitian ini membahas mengenai gambaran pelaporan insiden keselamatan pasien di rumah sakit di Indonesia beserta faktor-faktor yang memengaruhinya, ditinjau dari faktor individu, organisasi, dan pemerintah. Tujuan penelitian ini adalah didapatkannya informasi mengenai faktor-faktor yang brpengaruh terhadap pelaporan insiden keselamatan pasien di rumah sakit di Indonesia. Penelitian ini menggunakan metode literature review dengan basis data Garuda Kemendikbud, Rama Kemendikbud, Directory of Open Acces Journals (DOAJ), Library UI, Science Direct, PubMed, ProQuest, dan Scopus. Hasil penelitian didapatkan bahwa rumah sakit di Indonesia sudah memiliki regulasi yang mengatur mengenai pelaporan insiden kselamatan pasien. Sistem pelaporan yang digunakan masih berbasis manual, dan praktik pelaporan belum bisa dikatakan sukses karena masih adanya budaya menghukum, jaminan kerahasiaan pelapor masih diragukan, pelaporan belum tepat waktu, dan umpan balik masi minim. Dari hasil penelitian juga diperoleh faktor yang dapat memengaruhi pelaporan insiden keselamatan pasien di rumah sakit adalah faktor individu (pengetahuan, ketakutan, beban kerja, dan motivasi), faktor organisasi (umpan balik, sistem pelaporan, kerahasiaan, sosialisasi dan pelatihan, serta budaya keselamatan), dan faktor pemerintah dalam hal kebijakan.

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Patient safety in hospitals is still a crucial issue worldwide, because hospitals are service institutions that seek to cure patients. So patient safety becomes a necessity, it is hoped that there will be no patient safety incidents (zero incidents). One way to control the increasing number of incidents in hospitals is to utilize a reporting system. This study discusses the description of patient safety incident reporting in hospitals in Indonesia and the factors that influence it, in terms of individual, organizational, and government factors. The purpose of this study was to obtain information about the factors that influence the reporting of patient safety incidents in hospitals in Indonesia. This study uses a literature review method with the Garuda Ministry of Education and Culture database, Rama Kemendikbud, Directory of Open Acces Journals (DOAJ), UI Library, Science Direct, PubMed, ProQuest, and Scopus. The results showed that hospitals in Indonesia already have regulations governing patient safety incident reporting. The reporting system used is still manual-based, and reporting practices cannot be said to be successful because there is still a punitive culture, guarantees for the confidentiality of whistleblowers are still in doubt, reporting is not timely, and feedback is still minimal. From the results of the study, it was also found that the factors that can affect the reporting of patient safety incidents in hospitals are individual factors (knowledge, fear, workload, and motivation), organizational factors (feedback, reporting systems, confidentiality, socialization and training, and safety culture), and government factors in terms of policy."

"Berdasarkan laporan, KKPRS di Indonesia terjadi insiden keselamatan pasien seperti 249 KTD dan 283 KNC. Membuktikan masih kurangnya jaminan keselamatan pasien di rumah sakit. Keselamatan pasien adalah prioritas utama yang dilakukan rumah sakit sebagai pemberi pelayanan kesehatan. Untuk terhindar dari insiden, rumah sakit harus menerapkan sasaran keselamatan pasien. Sasaran keselamatan pasien dibuat agar rumah sakit terdorong untuk melakukan perbaikan dalam keselamatan pasien. Tujuan penelitian adalah mengetahui penerapan sasaran keselamatan pasien berdasarkan pendekatan sistem. Penelitian ini menggunakan literature review menggunakan data sekunder dari pencarian online yaitu Google Scholar dan GARUDA. Hasil pencarian literatur mendapatkan 5 artikel tahun 2017-2019 yang menganalis penerapan sasaran keselamatan pasien berdasarkan input, proses, dan output. Hasil penelitian menunjukkan, komponen input masih kurang optimal yaitu kebijakan/SOP; SDM; diklat & sosialisasi; metode; sarana prasarana; dana; dan organisasi. Pada proses ditemukan masih adanya tenaga kesehatan yang belum menerapkan prosedur pada sasaran keselamatan pasien yang telah ditentukan. Output yang dihasilkan adalah belum adanya rumah sakit yang dapat mencapai target sasaran keselamatan pasien yang telah ditetapkan. Kesimpulannya adalah masih belum tercapainya penerapan sasaran keselamatan pasien di rumah sakit karena masih kurang optimalnya komponen input dan proses. Rumah sakit dapat meningkatkan sumber daya untuk membantu tenaga kesehatan dalam penerapan sasaran keselamatan pasien.

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Based on the KKPRS report, in Indonesia there were patient safety incidents, such as 249 adverse events and 283 near miss incident. Proving the lack of guarantees for patient safety in hospitals. Patient safety is a top priority for hospitals as health care providers. To avoid incidents, hospitals must implement patient safety goals. Patient safety goals are designed to encourage hospitals to make improvements in patient safety. The purpose of this study is to determine the application of patient safety goals based on a system approach. This study was conducted with a literature review approach that uses secondary data from online searches, such as Google Scholar and GARUDA. The results of the literature search found 5 articles from 2017-2019 that analyze the application of patient safety goals based on input, process, and output. The results showed that the input components were still less than optimal, namely policies/SOP; human resources; training; method; infrastructure; fund; and organization. In the process, it was found that there were still health workers who had not implemented the procedures of the patient safety goals. The resulting output is there are no hospitals that can achieve the patient safety goals that have been set. The conclusion is that the application of patient safety goals in hospitals has not yet been achieved because the input and process components are still lacking. Hospitals can increase resources to assist health workers in applicating patient safety goals."