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Jurnal Manajemen Pelayanan Kesehatan
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Articles 26 Documents
Search results for , issue "Vol 15, No 04 (2012)" : 26 Documents clear
NURSING ERRORS DI UNIT PERAWATAN INTENSIF Fitri Haryanti, Budi Santoso Andreasta Meliala
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Background: The complexity of care processes, patient’scritical condition, high workload, and high level of psychologicalstress among the nurses in the Intensive Care Unit (ICU) couldlead to potential nursing errors (NE). This research aims toidenti fy nursing errors, categories of pat ient harm,nurses’profile, and the contributing factors perceived by thenurse in the ICU of Dr. Oen Surakarta Hospital.Methods: This was an observational study conducted usingobservation method with TERCAP modification instrument toidentify any nursing practices in ICU to patients that wereadmitted during one-month study period. In total, 115 patientswere observed and the analysis was conducted descriptively.Results: We found 8 types of 15 NE events, i.e. self extubation(26,66%), uprooted of IV line (20%) and NGT (13,33%), wrongdose (13,33%), omission (6,67%), wrong reason (6,67%), reprickingin blood sugar examination (6,67%), and phlebitis dueto wrong route (6,67%). Eight events (53,33%) did not harmthe patients and the other 7 events (46,67%) harmed thepatients temporarily. The profile of nurses involved was mostlywith diploma education (93,33%), having special education/training (80%), and more than 3 years working period in theICU (86,67%). Eight TERCAP categories were related tomedication errors (33,33%), documentation errors (26,67%),lack of attentiveness (73,33%), inappropriate clinical judgment(73,33%), lack of prevention (26,67%), lack of/inappropriateintervention (13,33%), missed/mistaken interpretation(33,33%), and lack of professional responsibility (40%). Whilethe highest perceived contributing factor was overloaded task(73,33%).Conclusion: The common type of events was self-extubation.No permanent harm was found. This study recommendscontinuous dissemination on patient safety for nurses toencourage reporting of NE events.Keywords: intensive care, nursing errors, nursing practices
HEALTHCARE FAILURE MODE AND EFFECT ANALYSIS: PROSES PELAYANAN OPERASI DI RUMAH SAKIT Sri Andarini, Indiati Viera Wardhani
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Background: Most of medical errors are preventable. Highnumber of adverse event and near miss cases in hospitalsindicate opportunity for improvement. Therefore, efforts toidentify potential risks, recognize event as early as possible,and set a barrier mechanism through implementation of HealthCare Failure Mode and Effect Analysis (HFMEA) are required.This research was aimed to identify the risk of patient safetyincident (failure mode), in surgery care processes, the causeof failure mode in every stage and the prevention strategyusing HFMEA in hospital setting.Methods: This study employed an observation study to applyHFMEA in surgical care processes. Data were collected throughdirect observation of surgical preparation and procedures inthe ward and operating theatre, 18 interviews as well asdocument analysis and focus group discussions.Result: We found 25 activities that were not performed orpartially performed leading to 26 potential failure modes andfour critical patient safety incidents. The main cause of thepotential risk is non-effective communication. This is causedby neglected or violation due to frequent care transitionsbetween departments and shifts, lack of supervision, lack ofnurse competence, and absence of full-time surgeonts. Thesefindings show lack of patient safety culture as the underlyingcause.Conclusion: Poor communication and care transition is themain causes of potential safety incident in surgery careprocess. This can be prevented by process redesign andhealth care teamwork improvement.Keywords: communication, health failure mode and effectanalysis, surgery care
PRAKTIK KESELAMATAN PASIEN BEDAH DI RUMAH SAKIT DAERAH Fitri Haryanti, Eva Tirtabayu Hasri Yayuk Hartriyanti
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Background: Surgery is an important care intervention. Indeveloping countries, World Health Organization (WHO)estimates 50% of complication and death due to surgery ispreventable. Therefore, WHO introduces safe surgery andsurgical safety checklist (SSCL) as an attempt to improve patientsafety, reduce mortality and disability. This study aimed todescribe the practice of safe surgery by using SSCL in theoperating room of Sumbawa District hospital.Method: A cross-sectional study was conducted. Subjectswere all patients who had major surgery between May-July2012 were recruited. Ninety three patients, consisting of 44elective and 49 emergency surgeries were recruited.Observation was carried out using SSCL and data wereanalyzed descriptively.Result: Implementation of SSCL was consistent (100%) onthe completeness of anesthesia check and pulse oximeter(sign in phase), and review of sterile surgical equipment (timeout phase). None of the checklist items in sign out phase wasfully implemented.Conclusion: Implementation of safe surgery has not beenfully implemented in major surgery. Therefore, efforts shouldbe made to introduce and disseminate SSCL to the surgicalteams in order to improve patient safety.Keywords: surgical safety checklist, dist rict hospital,observational study
FAKTOR PENYEBAB MEDICATION ERROR DI INSTALASI RAWAT DARURAT FACTORS AFFECTING MEDICATION ERRORS AT EMERGENCY UNIT Alimin Maidin, Rusmi Sari Tajuddin Indrianty Sudirman
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Background: Incident of medication errors is an importantindicator in patient safety and medication error is most commonmedical errors. However, most of medication errors can beprevented and efforts to reduce such errors are available.Due to high number of medications errors in the emergencyunit, understanding of the causes is important for designingsuccessful intervention. This research aims to identify typesand causes of medication errors.Method: Qualitative study was used and data were collectedthrough interviews, observation and secondary document.Result: Prescribing errors identified were dosage error anddosage wri ting error, unclear prescription wr iting, andincomplete administration and prescription. Dispensing errorincludes misreading prescription of look alike sound alike drugs,inaccurate number of drugs, drugs not accordance to theprescriptions, inaccurate dosage given and incorrect form.While for administration error, we found inaccurate time andtechnique of administration, drugs given to a wrong patientwith similar identity. The cause of prescribing error is due todoctor’s knowledge, poor handwriting, and family interruption.The following factors may cause administration error: individualcharacter, workload, collaboration with family, and poor familyknowledge on drug collection procedures.Conclusion: Different forms of medication errors and theirpotential causes were identified from this study. Openness indiscussing this topics and acceptance of different types oferrors are critical in order for the hospital to implementsuggested actions to reduce medication errors.Key Words: patient safety, medication error, emergency unit
ANALISIS BIAYA MUTU DALAM PENINGKATAN MUTU LAYANAN KESEHATAN DI PUSKESMAS Tjahjono Koentjoro, Tri Astuti Sugiyatmi Muhammad Arifai
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Background: Customer complaints and even law suits reflectpoor quality of care. Supports for quality improvement hasbeen low. Therefore calculation of cost of quality in PublicHealth Centers (PHC) is needed to allocated budget. This studyaims to obtain cost of quality and efforts to improve the qualityof PHC through commitment of top management and support ofstakeholders in Sleman PHC, Yogyakarta Special Province.Method: The research used a case study with multiple-casesembedded design. The cases were four PHCs that apply qualitymanagement system (QMS) and two PHCs that have not aplliedit yet. The 2010 budget documents were analyzed with thePAF instrument (prevention, appraisal, failure). Qualitative datawere collected from informant interviews.Result: The average cost of quality in PHCs with QMSimplementation was IDR 70,000,803; while in the non-QMSimplementation reached IDR 31,421,450. The proportion of costof quality in PHCs implementing QMS was 67% for prevention,33% for appraisal and none for internal-external failures. Whilefor the non-implementing QMS, the proportions were 92%,7%, 0%, and 1% sub sequently.Conclusion: The average cost of quality in PHCs with QMS is2.2 times higher than the non-QMS. However, its cost forprevention needs to be improved, through commitment of topmanagement and support from stakeholders.Keywords: cost of quality, QMS, prevention, failure, appraisalcost, Public Health Center
RISET OPERASIONAL PENINGKATAN KINERJA TIM KESELAMATAN PASIEN BERDASARKAN STANDAR INTERNASIONAL ENAM TUJUAN KESELAMATAN PASIEN Widodo J. Pudjirahardjo, Moh Ainul Yaqin Darmawan Setijanto
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Abstract

Background: Patient safety emphasizes reporting, analysis,and prevention of medical error that often leads to adversehealthcare events. In 2010, there were 60 incidents related topatient safety in Nyai Ageng Pinatih Hospital, Gresik, and thiscondition was incompatible with the hospital mission to providehealth care professionally and safely. The objective was toimprove the performance of patient safety team at motherchildhospital, Nyai Ageng Pinatih Gresik based on the SixGoals International Patient Safety (SGIPS) standards.Method: This research was an operational research.Respondents were 41 patient safety team members at theHospital. The intervention was carried out from May 7 untilJune 30, 2011, with pre and postintervention observations.Results: Conditions for the implementation of patient safetybased on SGIPS standards increased from 2.5 to 4.34 and thecriterion value is still on “not met”. Most individuals showedhigher awareness, after the intervention; Achieved increasedvalue of knowledge and participation and decreased personalobjective team members after the intervention. All individualparameters on team leader (coaching, monitoring, eliminateproblems performance, and set and update objectives)increased after the intervention.Conclusion: The study showed changes in awareness, personalobjectives, participation, and knowledge of patient safetyteam member after intervention. Coaching, monitoring, eliminateperformance problems, and set objectives and patientsafety team leader contributes to patient safety team performance.Keywords: patient safety, Six Goal International Patient Safety,team
KEBIJAKAN SUBSIDI KESEHATAN BAGI KELUARGA MISKIN DAN KONSUMSI ROKOK DI INDONESIA TAHUN 2001 DAN 2004 Suryawati, Chriswardani
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Abstract

Korespondensi
KESELAMATAN PASIEN DAN MUTU PELAYANAN KESEHATAN: MENUJU KEMANA? Hanevi Djasri, Adi Utarini
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Editorial
DAMPAK JAMPERSAL PADA RASIO TENAGA KESEHATAN TERHADAP PASIEN DAN KELUARAN KLINIS PASIEN BERSALIN Iwan Dwiprahasto, Nur Hayati
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Background: Jampersal is an insurance scheme policy forfree maternal delivery from Ministry of Health Republic ofIndonesia since 2011. Its general purpose is to decreasematernal and infant mortality through access to obstetricservices in many healthcare facilities. This program is expectedto increase patient visits and affect the health worker-to-patientratio and obstetric outcome as a result.Objective: To measure the effect of Jampersal implementationon health worker-to-patient ratio and obstetric outcome inObstetric Emergeny Room Department (OERD) of CiptoMangunkusumo Hospital Jakarta.Method: This study applied a pre-post test quasi-experimentaldesign. Subjects were chosen randomly from all deliveries.Number of all health workers, total member of patients in OERDin this tertiary care hospital were collected nine months beforeand af ter Jampersal implementation. Health worker perprofessional group per work shift were measured manuallyand divided by the number of patients per shift to obtain healthworker-to-patient ratio. Complication as an obstetric outcomewas measured from the medical record.Result: On average, health worker-to-total patient ratiodecreases f rom 5,53±2,36 to 3,73±1,04. Health worker-to-OERD inpatient ratio decreases from 7,97±6,61 to 1,34±0,49after Jampersal. While complication rate increases from 39,5%to 52,9% but not statistically significant.Conclusion: Jampersal affects health worker-to-patient ratiosignificantly which decreases the rate.Keywords: Jampersal, free maternal delivery policy, healthworker-to-patient ratio, obstetric outcome, complication.
Introduction to Healthcare Quality Management Mikrajab, Muhammad Agus
Jurnal Manajemen Pelayanan Kesehatan Vol 15, No 04 (2012)
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Resensi

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