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"A patient undergoing surgery faces great physiologic and psycologic stress, so nutritional demands are greatly increased during this period and deficiencies can easily develop. If this deficiencies are allowed to develop and are not met in screening, serious malnutrition and clinical problem can occur. Therefore careful attention must be given to a patient's nutritional status in preparation of surgery, as well as to the individual nutritional needs. If these needs are met complications are less likely developing. Nutritional resources provide for rapid recovery. Proper nutrition can speed healing in surgical patients with major trauma, severe malnutrition, burns and other severe illnesses. New techniques for tube feeding, intravenous nutrition for patients with serious weight loss due to gastrointestinal disorders and use of supplements can hasten wound healing and shorten recovery times. "

"Pendahuluan :Dengan meningkatnya bidang perumahsakitan pada saat sekarang ini yang juga diikuti dengan peningkatan dari "demand" masyarakat akan pelayanan kesehatan yang bermutu, maka diperlukan pengelolaan suatu rumah sakit yang efisien dan bermutu.Namun dalam hal pengelolaan tersebut banyak faktor yang berperan, disamping sumber daya yang ada pada rumah sakit juga ada beberapa indikator sebagai tolok ukur keberhasilan / efisiensi dari suatu rumah sakit diantaranya adalah lama hari rawat dari pasien rawat inap.Pada penelitian ini akan dianalisa faktor-faktor yang berhubungan dengan lama hari rawat pasien operasi di bagian kebidanan dan penyakit kandungan rumah sakit PMI Bogor, oleh karena sebagian bestir ( 72.28 %) dari 267 pasien yang mengalarni salah satu dari operasi seksio sesaren salpingooforektomi atau hietoroldomi mongalami perpanjangan lama hari rawat.Tujuan peneltian :Adapun yang menjadi tujuan penelitian ini, adalah untuk melakukan analisa deskriptif faktor-faktor yang berhubungan dengan lama hari rawat pasien yang mengalami salah satu dan operasi seksio sesarea, salpingooforektomi atau histerektomi di bagian kebidanan dan penyakit kandungan nunah sakit PMI Bogor.Metodologi penelitian:Rancangan / disain penelitian ini, adalah merupakan studi "cross sectional"Populasi penelitian adalah, pasien rawat inap di bagian kebidanan dan penyakit kandungan yang mengalami salah satu dari operasi seksio sesarea, salpingooforektomi atau histerektomi periode Januari sanipai dengan Desember 1994, sedangkan sampel penelitian adalah total populasi yaitu sebanyak 267 kasus yang mengalami salah satu dari ketiga nrncam operasi tersebut. Dan data yang digunakan merupakan data sekunder yang berasal dari catatan medik pasien di bagian rekam medik. Analisa yang dipergunakan adalah analisa univariat untuk melihat distribusi frekuensi dan analisa bivariat yang dalam hal ini dipergunakan penghitungan Odd Ratio dan uji Chi square.Hasil penelitian:Dari tujuh variabel yang diajukan ternyata lima variabel yang menunjukkan hubungun yang benuakna secara statistik dengan lama hari rawat pada operasi seksio sesarea, empat variabel pada operasi salpingooforektomi dan tiga variabel pada operasi histerektomi,dalam hal mana, tiga variabel ( sifat operasi, kelas perawatan dan penaggung jawab biaya ) menunjukkan hubungan yang bermakna secara statistik dengan lama hari rawat pada ketiga macaru operasi tersebut.Kesimpulan :Dari hasil penelitian ini, maka dapat disimpulkan bahwa dari ketiga variabel yang menunjukkan hubungan yang bermakna secara statistik terhadap lama hari rawat, ternyata variabel sifat operasi dan kelas perawatan merupakan variabel yang selalu konsisten, artinya bahwa kedua variabel tersebut selalu muncul dan tetap pada setiap tindakan operasi. Dari variabel alasan pulang, disini peran dokter dalam menentukan kepulangan pasien dari rumah sakit mempunyai kontribusi yang cukup besar, hal ini dapat dimengerti oleh karena pasien yang pulang dari rumah sakit akan merasa puas apabila dipulangkan oleh dokter yang merawatnya. Sebaliknya variabel infeksi luka operasi menunjukkan hubungan yang tidak bermakna secara statistik dengan lama hari rawat pada ketiga macam operasi tersebut, hal ini antara lain oleh karena keterbatasan pada penelitian ini.Saran :Oleh karena variabel sifat operasi dan kelas perawatan mempunyai hubungan yang cukup erat dengan lama hari rawat, maka disurankan pada pihak rumah sakit bila menangani kasus-kasus yang termasuk dalam kategori ini hendaknya lebih intensif sehingga diharapkan terjadinya perpanjangan lama hari rawat dapat diperkecil.Kiranya pihak rumah sakit memotivasi tenaga medis khususnya dokter ahli kebidanan dan penyakit kandungan untuk mempertimbangkan kepulangan pasien, sehingga diharapkan dapat membantu dalam upaya menekan terjadinya perpanjangan lama hari rawat.

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The Factors those to be Connected With The Length of Stay of The Surgical Patient in The Section of Obstetrics and Gynecology at The Hospital PMI BogorIntroduction :

Along with the increasing of the present day field of hospitalization that to be followed by the increasing of the public's "demand" to obtain a healthy service with a good quality, in this case that the hospital itself should be handled in an efficient manner and in a good quality of service. However, in the handling itself there are so many factors with their own roles, not only due to the resource that is present in the hospital itself but also due to some indicators those exist as a measure of success 1 efficiency of the hospital, such as the length of stay of the inpatient. In this research, all factors those to be connected with the length of stay of the surgical patient in the section of obstetrics and gynecology at the hospital of PMI Bogor, because a large part of 267 patients has one of the surgical inpatients of the sectio caesarea, salpingooforectomy or histerectomy those have a lengthening of the length of stay.

The goal of the research :

The goal of this research is an analytical description of the factors those to be connected with the length of stay of the in patient that has one of the surgical treatments of the sectio caesarea, salpingooforectomy or histerectomy in the section of obstetrics and gynecology at the hospital of PMI Bogor.

Methodology of the research :

The design of this research is a "cross sectional" study.

The population of the research is the inpatient in the section of obstetrics and gynecology that has one of the surgical treatments of the sectio caesarea, salpingooforectomy or histerectomy during a period from January to December 1994, while the sampling of the research is a total population of the 267 cases those to be involved in one of the three kinds of the surgical treatments. The data that to be used is a secondary data that to be obtained from the medical record of the patient in the section of the medical copy. The analysis those to be used are, univariant analysis to see the distribution of the frequency, and the bivariant analysis use Odd Ratio and Chi square test for calculating.

The result of the research :

Of the seven variables those to be proposed in fact, only five of them show a meaningful connection statistically with the length of stay for the surgery of sectio caesarea, four variables for the surgery of salpingooforectomy and three variables for the surgery of histerectomy, however the three variables such as ( the nature of the surgery, the clue of the treatment and the underwriter of the cost) show a meaningful connection statistically with the length of stay for three kinds of the surgeries.

Conclusion :

The result of this research provides a conclusion that from the three variables those show a meaningful connection statistically toward the length of stay, in fact the variable of the nature of the surgery and the class of the treatment are the variables those always have been consistent, in another words both variables always present and exist in the measure of the surgery. By the variable of the reason of the homed patient, in this case the role of a physician to decide a homed patient out of the hospital has sufficiently large contribution, however it is understood that a homed patient that out of the hospital is no doubt owing a satisfaction because the patient is allowed to go home by a permission from the doctor who has treated him. In contrast that the variable of the infection wound of surgery shows an unmeaning connection statistically towards the length of stay against the three kinds of the surgeries, it is due to the limitation owned by this research.

Suggestion :

It is clear enough, both variables such as the nature of the surgery and the class of the treatment have a very close connection toward the length of stay, and therefore to be suggested, that the hospital as a medical center would handle all the cases in this category in more intensive way, to be hoped that it could decrease the lengthening of the length of stay. To be that the hospital as a medical center could motivate the medical persons especially the horned patient, in this case to be hoped that it could help the effort in decreasing the lengthening of the length of stay.

References : 38 ( 1969 - 1994 )."

"ABSTRAKLatar Belakang: Banyaknya pasien yang masuk ke Instalasi Gawat Darurat dengan spektrum penyakit serta derajat berat penyakit yang bervariasi, menimbulkan kesulitan bagi para dokter melakukan penilaian cepat berdasarkan data subjektif saja. Sistem skor Worthing Physiological Scoring System dapat digunakan untuk memprediksi mortalitas pasien non bedah karena menggunakan variabel-variabel yang mudah dan cepat diperoleh, sehingga lebih praktis dalam penggunaannya Oleh karena terdapat perbedaan karakteristik populasi pasien, maka perlu dilakukan validasi untuk mengetahui performa Worthing Physiological Scoring System tersebutTujuan: Menilai performa kalibrasi dan diskriminasi WPS dalam memprediksi mortalitas pasien non bedah selama di IGD Rumah Sakit Cipto Mangunkusumo (RSCM).Metode: Penelitian ini merupakan studi kohort retrospektif pada populasi pasien non bedah yang masuk ke IGD RSCM dari bulan Oktober sampai November 2012. Variabel yang diukur adalah frekuensi pernapasan, denyut jantung, tekanan darah sistolik, suhu tubuh, saturasi oksigen perifer, dan tingkat kesadaran. Luaran yang dinilai adalah kondisi pasien (hidup atau meninggal) selama di IGD RSCM. Performa kalibrasi dinilai dengan uji Hosmer-Lemeshow. Performa diskriminasi dinilai dengan area under the curve (AUC).Hasil: Selama penelitian didapatkan 774 subjek memenuhi kriteria penerimaan dengan 78 (9,6%) subjek di antaranya meninggal. Uji Hosmer-Lemeshow menunjukkan χ2 = 0,84 (p = 0,840). Nilai AUC 0,78 (IK 95% 0,723-0,847).Simpulan: Worthing Physiological Scoring System memiliki performa yang baik dalam memprediksi mortalitas pasien non bedah yang masuk ke IGD RSCM.

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ABSTRACTBackground: Patients referred to Emergency Room (ER) represent a broad spectrum of disease severity, led difficulties for a physicians to conduct rapid assessments based on subjective data only.Worthing Physiological Scoring System could be use to predict mortality in non-surgical patients using variables which are obtained easily and rapidly, making it more practical in use. Because there are differences in the characteristics of the patient population, Worthing Physiological Scoring System should be validated.Objectives: The aim of this study was to assess the performance of Worthing Physiological Scoring System in predicting mortality of non-surgical ER in Cipto Mangunkusumo Hospital (RSCM).Methods: This was a retrospective cohort study. We collected data of non-surgical patients who admitted ER during October to November 2012. The variables measured were respiratory rate, heart rate, systolic blood pressure, body temperature, peripheral oxygen saturation, and level of consciousness. The primary outcomes was death in ER RSCM. Hosmer-Lemeshow test were used to evaluate calibration of Worthing Physiological Scoring System. Discrimination was evaluated with area under the curve (AUC).Result: A total of 774 non surgical patients were included in this study, from the patients, 78 (9.6%) subjects died. Calibration was resulted by Hosmer-Lemeshow test showed χ2 = 0.84 (p = 0.840). The AUC was 0.78 (95% CI 0.723 to 0.847).Conclusion: Worthing Physiological Scoring System had a good performance in predicting mortality of non-surgical patients in ED RSCM. "