. Hudiyono
Faculty of Medicine, Sebelas Maret University

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Prevalensi Pneumonia Nosokomial pada Pasien Rawat Inap di ICU RSUD Dr. Moewardi Periode April-Mei 2012

Nexus Kedokteran Klinik Vol 2, No 2 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background  : Infectious diseases are the main causes of morbidity and mortality in the world. The prevalence of nosocomial infections still high  in development countries. Nosocomial infections often occured, especially in ICU’s patients, it is around 25-33%. A minimum research of the incidence of hospital acquired pneumonia in Dr. Moewardi Hospital is the background of this research. Thorax photo were obtained when the patient first entered the hospital and after being treated in hospital for more than 48 hours. It used as one of the diagnostic tests to assist the prevalence of hospital acquired pneumonia on ICU’s patient. Methods : This is a descriptive observational research method with a cross-sectional approach to obtain the prevalence of hospital acquired pneumonia in ICU Dr. Moewardi Hospital during April-May 2012. The sample is done by using a purposive sampling. The population of this study was all patients who are hospitalized in the ICU Dr. Moewardi Hospital in Surakarta during April-May 2012. Results : Total sample are 72 patients. The result of this research shows that the prevalence of hospital acquired pneumonia in April-May 2012 on patients who are hospitalized in the ICU Dr. Moewardi Hospital is 8.3%. The middle age group (48-64 years) and old age (65-88 years) are the greater group of getting risk of hospital acquired pneumonia. Discussion : The prevalence of  hospital acquired pneumonia is 8.3%. This may be caused by the use of respiratory mechanic devices, the immunocompromised patients,  hospital environmental factors, the use of immunosuppressive drugs and the time of patients hospitalized. It is recommended that all of medical team of this hospital need to develop an effective program to control and prevent nosocomial pneumonia infection. Key words : prevalence, hospital acquired pneumonia, thorax photo  

Hubungan Obesitas Dengan Kejadian Infark Serebral Pada Pasien Rawat Inap Bangsal Saraf RSUD Dr. Moewardi

Nexus Kedokteran Klinik Vol 2, No 2 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background  :Obesity is closely associated with increased risk of atherosclerosis disease. Atherosclerosis occurs when a portion of the surface of the large arteries forming plaque. As a result, the plaque will cause blood vessel disorders, even cerebrovascular disease. Cerebral infarction is a cerebrovascular disease that can cause a drop in the supply of oxygen and glucose to a particular part of the brain that eventually lead to the onset of a stroke. The cerebral infarction’s high occurrence rate were the reason that made the researcher wanted to find out if there is a relationship between obesity and cerebral infarction in patients hospitalized in the neurological ward RSUD Dr.Moewardi. Methods :This was an observational analytic research with cross sectional design. This research was done in RSUD Dr.Moewardi. The sampling was done in consecutive sampling. This research’s populations were patients hospitalized in the neurological ward RSUD Dr.Moewardi during November-December 2012. Results :Total sample are 42 patients. The result of this research shows there were 21 samples of cerebral infarction case, which consisted of 17 obesity patients and 4 non-obesity patients. The other 21 samples were the non-cerebral infarction patients which consisted of 3 obesity patients and 18 non-obesity patients. The obtained data were analyzed using Chi-Square test and resulted in a significant relationship ( p< 0,01). Conclusions :There was a relationship between obesity and cerebral infarction in patients hospitalized in the neurological ward RSUD Dr.Moewardi. Key words :relationship, obesity, cerebral infarction.

Efektivitas Desinfektan Karbol 4% di Ruang Isolasi Barat ICU RSUD Dr. Moewardi

Nexus Biomedika Vol 2, No 2 (2013): Nexus Biomedika
Publisher : Nexus Biomedika

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Abstract

Nosocomial infection still becomes a global health problem. An attempt to reduce the risk of nosocomial infections in the ICU (intensive care unit) room of RSUD Dr. Moewardi, 4% carbol has been used routinely in disinfection. This study was to know the effectiveness of 4% carbol disinfectant in West Isolation Room of ICU in RSUD Dr. Moewardi. This study was an analytical observational research with a cross sectional approach. The samples collected from ICU resulted from three groups. Each group was 15 samples, collected from swabbing the floor and the wall (grown on agar), and from the air (grown on blood agar). For each group, 5 samples were taken at 6 am (1 hour before disinfection), at 9 am (2 hours after disinfection) and at 12 pm (5 hours after disinfection). The data were analyzed using Wilcoxon experiment Based on the standard of germs limit on wall, floor (5-10 colony/cm2) and air (≤200 cfu/m3) at intensive care unit, the result from swabbing the wall and air samples showed that the disinfection was 100% effective. Whereas, the result from swabbing the floor was only 13.33% effective. Between germs number from swabbing the wall collected at 6 am and 9 am represented a significant reduction (p = 0.042). On the other hand, there was no significant reduction of germ number between which were collected at 6 am and 12 pm (p = 0.068) as well as between 9 am and 12 pm (p = 1.000). In addition, there was also no significant reduction of germs number resulting from swabbing the  floor between collected at 6 am and 9 am (p = 0.080); 6 am and 12 pm (p = 0.080); and 9 am and 12 pm (p = 0.068). Furthermore, the number of air germs between collected at 6 am and 9 am represented a significant reduction (p = 0.043). But, there was no significant reduction between collected at 6 am and 12 pm (p = 0.225), as well as  at 9 am and 12 pm (p = 0.715). Disinfection with 4% carbol in west isolation room of ICU RSUD Dr. Moewardi showed  effectively controlling germs number on the wall and the air, but it was not effectively controlling on the floor. Keyword: disinfectant, carbon 4%, germs number.

Perbedaan Efektivitas antara Sterilisasi Dialyzer secara Manual dan Otomatis di Rumah Sakit DR.Moewardi

Nexus Biomedika Vol 2, No 2 (2013): Nexus Biomedika
Publisher : Nexus Biomedika

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Abstract

Background: Dialyzer is a critical medical equipment having high risk of microorganism contamination. Because of economical reason, dialyzer reuse is performed as first choice in Indonesia. The making of dialyzer reuse starts from rinsing, priming test and sterilization itself. Sterilization method of dialyzer that has been carried out in Rumah Sakit Dr. Moewardi is manual and automatic sterilization. Method: This was an observational study using cross sectional design. Samples taken by consecutive sampling technique were collected from the last rinsing of NaCl right before the dialyzer was used. This NaCl samples were collected from dialyzer which were sterilized manually and automatically, each, 15 samples. The difference of posistive growth of bacteria cultures of both methods was analyzed by Chi square test, while the difference of the number of colony forming unit was analyzed by independent T test. Result: Fifteen samples of the last rinsing of NaCl from dialyzer sterilized manually showed there were 10 samples positive contaminated and 5 samples negative. While from dialyzer sterilized automatically showed there were 8 samples positive contaminated and 7 samples negative. All positive samples were contaminated by positive Gram bacteria. The statistical analyses showed no significant difference of both based on quality (p = 0.456) and quantity (p = 156). Conclusion: There was bacterial contamination as many as 10 samples (66.6%) of dialyzer which was sterilized manually and 8 samples (53.3%) of dialyzer which was sterilized automatically. There was no significant difference statistically on the effectiveness between manual and automatic sterilization. Keywords: dialyzer reuse, manual sterilization, automatic sterilization.

Uji Sterilitas Instrumen Bedah Selama Penyimpanan di Kamar Operasi IGD RSUD Dr. Moewardi

Nexus Biomedika Vol 2, No 2 (2013): Nexus Biomedika
Publisher : Nexus Biomedika

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Abstract

Background: Surgical Site Infection (SSI) in RSUD Dr. Moewardi still occurs frequently. SSI strongly relates to the sterilization quality of surgical instrument which is determined by the stage of sterilization process that includes cleaning, packaging, ordering in sterilizer, sterilizing process, distribution, and storage. The maximum storage length of sterile surgical instrument in IGD operating chamber of RSUD Dr. Moewardi is seven days. This research aimed to know the sterilization rate of surgical instrument stored in IGD operating chamber of RSUD Dr. Moewardi. Methods: Five samples were taken from post-steriliziation surgical instrument swab with varied storage length, those were 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, and 7 days. A total of 35 samples were collected based on the rule of thumb with simple random sampling technique. Data were analyzed using Chi Square test. Results: The result of 5 samples of surgical instrument swab after 1 day  storage was 1 positive sample with contamination and 4 negative samples. From 5 samples of surgical instrument swab after 2 and 3 days storage, there was not any positively contaminated samples. Five samples of surgical instrument swab after 4 and 5 days storage showed 4 samples positively contaminated and 1 sample negative. From 5 samples of surgical instrument swab after 6 and 7 days storage, there were 3 samples positively contaminated and 2 samples negative. The microorganisms of contaminant found were gram positive bacteria. The statistical analysis showed a significant relationship between the length of surgical instrument storage and the contamination of microorganism (p = 0.017). Conclusions: There was a significant difference of bacteria growth rate on surgical instruments based on storage length. Surgical instruments stored in IGD operating chamber of RSUD Dr. Moewardi > 3 days were 33 times more likely contaminated than the surgical instruments stored ≤ 3 days (OR = 32,67; p < 0,001). Keywords: sterility, contamination of surgical instrument, storage length.