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Epidemiology of human avian influenza in Indonesia, 2005-2009: a descriptive analysis Adisasmito, Wiku
Medical Journal of Indonesia Vol 19, No 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Aim The study set out to better understand the epidemiology, natural history, therapeutic management and outcomes associated with confirmed human cases of Avian Influenza (AI) in Indonesia.Methods This observational study utilized data from 93 cases with laboratory-confirmed H5N1 Influenza between September 2005 and August 2009. Cases were identified through records obtained from the Ministry of Health, as well as the Provincial health office and district health office records. Categorical data were analyzed with frequency tables, chi-square tests, and relative risks, and continuous data were analyzed using univariate statistics and Wilcoxon tests.Results Most subjects (54%) first presented to a physicianâs office or clinic. All of the subjects were hospitalized, and the vast majority (85%) had respiratory symptoms as their predominant symptom at presentation. There was no clear association of any of these case characteristics with survival. Cases with direct poultry exposure were 2.8 times more likely to receive oseltamivir treatment than those without direct exposure (RR = 2.89, 95% CI 1.44 â 5.78). While the overall number of survivors was small, cases with documented oseltamivir treatment were approximately 24% more likely to survive than cases for which oseltamivir treatment was not documented (RR 1.24; 95% CI: 0.34-4.58). In oseltamivir treated cases, the median time from symptom onset to start of antiviral treatment was 2.5 days in survivors compared to 7.0 days for those who died. Fatality, therefore, may be related to delay in initiation of treatment after presentation.Conclusions The data suggest that early treatment with the antiviral drug oseltamivir may play an important role in survival. However, a low clinical suspicion of disease likely remains an important impediment to early diagnosis. Therefore, a clear policy for the protocol of early diagnosis & treatment of febrile illness including influenza is necessary. (Med J Indones 2010; 19:64-70)Keywords: human avian influenza, antiviral drugs, oseltamivir, survival, Indonesia

Analisis Manajemen Risiko Penularan Virus COVID-19 Pada Dokter Dan Perawat Di Rumah Sakit X Tiffani Dwiarine Afifa; Wiku Bakti Bawono Adisasmito
Jurnal Manajemen dan Administrasi Rumah Sakit Indonesia (MARSI) Vol 5, No 2 (2021): Jurnal Manajemen dan Administrasi Rumah Sakit Indonesia (MARSI)
Publisher : LPPM Universitas Respati Indonesia

Selama pandemi COVID-19, rumah sakit perlu melakukan upaya perlindungan terhadap dokter dan perawat, yaitu dengan penerapan manajemen risiko yang baik. Dalam penelitian ini dilakukan analisis penerapan manajemen risiko terhadap pencegahan penularan infeksi COVID-19 pada dokter dan perawat di RS X dengan cara menganalisis elemen penting dalam penerapannya serta melihat hubungan elemen tersebut terhadap penilaian penerapan manajemen risiko. Penelitian ini menggunakan metode penelitian kuantitatif dan kualitatif paralel konvergen yang diolah secara univariat dan bivariat. Data dikumpulkan melalui wawancara mendalam dan penyebaran kuesioner daring. Hasil: Rumah sakit telah melakukan upaya demi tercapainya lingkungan kerja yang aman, seperti pembuatan area khusus COVID, penyediaan APD yang cukup, serta pengaturan durasi shift. Didapatkan korelasi signifikan (p-value <0.05) elemen yang diteliti dengan penilaian penerapan manajemen risiko, dengan nilai uji Spearman tertinggi 0.607 pada elemen komunikasi dan information. Kesimpulan: Elemen-elemen yang diteliti memiliiki hubungan terhadap penilaian penerapan manajemen risiko di RS X. Telah dilakukan berbagai upaya untuk melindungi dokter dan perawat dengan penerapan manajemen risiko yang sudah berjalan cukup baik, terlihat dari menurunnya angka terinfeksi pada pemeriksaan rutin. Masih ditemukan hambatan berupa keterbatasan sumber daya, karakter yang kurang disiplin, serta belum terciptanya komunikasi dan lingkungan jujur dengan sepenuhnya.Kata kunci: manajemen risiko, COVID-19, dokter, perawat

Rancangan Pola Karir Perawat Klinik di Rumah Sakit Tentara Jakarta Buyung Nazeli; Wiku Adisasmito
Jurnal Keperawatan Indonesia Vol 11 No 2 (2007): September
Publisher : Fakultas Ilmu Keperawatan Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.7454/jki.v11i2.188

AbstrakPerawat klinik di rumah sakit (RS) tentara memiliki pola dan pengembangan karir yang unik. Tujuan penelitian adalah untuk mengetahui gambaran pola karir yang efektif untuk pengembangan karir perawat klinik di RS tentara. Penelitian ini merupakan penelitian deskriptif kualitatif yang dilakukan di RS tentara Jakarta pada minggu I Maret sampai minggu IV April 2006 dengan 25 responden. Penelitian menggunakan pendekatan sistem yaitu masukan-proses-keluaran. Data primer diperoleh melalui wawancara mendalam dan dianalisis secara kualitatif. Sedangkan data sekunder diperoleh dari telaah dokumen yang berhubungan dengan peraturan dan kebijakan tentang pengembangan karir perawat klinik di rumah sakit dan suprasistem terutama dari Kesehatan Daerah Militer Jakarta Raya/ Kesdam Jaya. Hasil penelitian menunjukkan bahwa pengembangan tenaga keperawatan dilakukan melalui pendidikan dan pelatihan, dan hampir semua program merupakan program dari suprasistem. Pengalaman kerja perawat dalam pengembangan karirnya diperoleh melalui pengalaman jabatan dan kepangkatan, program mutasi dan promosi, pendidikan dan pelatihan, bimbingan para perawat senior, sedangkan khusus perawat militer penugasan lapangan dari suprasistem. Kebijakan dan peraturan tentang pengembangan karir perawat klinik tergantung dari suprasistem. Pola karir yang berlaku saat ini hanya pola karir structural sesuai dengan struktur organisasi dan tugas rumah sakit. Untuk itu perlu dibuat suatu bentuk pola karir fungsional berdasarkan pendidikan, pengalaman kerja, dan kompetensi perawat klinik baik militer dan PNS maupun sukarelawan.Â AbstractClinical Nurse in an army hospital has unique career & development pattern. This study aimed at finding out description on an effective career pattern for clinical nurses at army hospital. This was a qualitative study conducted from March-April 2006 involving 25 informants. Primary data was collected by in-depth interview and secondary data was collected from documentations related to policy and regulation in career development of clinical nurse. The data source was from the hospital and its governing institutions; i.e. Regional Army Office & Ministry of Defense & Security. The results showed there was unclear development pattern for clinical nurses in army hospital. Different status of the nurse in the hospital has different characteristic of development. Almost all of training programs at the hospital are directed by the governing institutions with little involvement from the hospital management. Working experience, as part of career development, is mostly achieved due to experience in the organization, military rank (army), employment grade (government official), rotation and promotion programs, education and training, and military field duty. The policy and regulation on career development of clinical nurses depend on the policy & decision of the governing institutions. This research develops career development patterns for all clinical nurses based on their status, clinical duty, and structural assignment. The career pattern developed is appropriate with nurseâ€™s education, work experience, and its competence.

Menghadapi Ancaman Pandemi: Analisis Sumber Daya Rumah Sakit Rujukan Avian Influenza di Jakarta Wiku Adisasmito; Mega Purba Sari; Amir Su’udi; Yusi Narulita
Jurnal Kesehatan Masyarakat Nasional Vol. 4 No. 2 Oktober 2009
Publisher : Faculty of Public Health Universitas Indonesia

Hingga kini, di Indonesia, pandemi Avian Influenza (AI) masih menjadi ancaman yang dapat menimbulkan banyak korban manusia dan kerugian ekonomi yang besar. Untuk mengantisipasi hal tersebut perlu persiapan dari rumah sakit rujukan AI secara matang khususnya di Jakarta yang merupakan provinsi dengan jumlah kasus AI terbesar. Tujuan dari penelitian ini adalah untuk mengetahui kemampuan sumber daya yang dimiliki rumah sakit rujukan AI RSPI Dr.Sulianti Saroso, RSUP Persahabatan dan RSPAD Gatot Soebroto dalam menghadapi ancaman pandemi AI. Penelitian ini menggunakan disain cross sectional, mengamati sumber daya rumah sakit meliputi fasilitas tempat tidur, peralatan, alat proteksi diri, dan obat-obatan. Metode perhitungan estimasi kebutuhan sumber daya menggunakan formula Radonovich LJ, et al. Hasil penelitian menunjukkan masih terbatasnya ketersediaan tempat tidur baik ICU maupunnon ICU, APD, serta oseltamivir, amoxicillin dan cairan Intravena di rumah sakit rujukan khusus AI apabila terjadi pandemi AI di DKI Jakarta. Dalam rangka siap siaga menghadapi pandemik influenza, disarankan menambahkan rumah sakit rujukan AI di DKI Jakarta dengan mempertimbangkan hasil penelitian ini dan menggunakan pendekatan scenario planning.Kata kunci: Avian influenza , pandemi, sumber daya, RS rujukanAbstractAvian Influenza (AI) pandemic has been threatening Indonesia people and may cause human fatality as well as huge economic lost. To anticipate any loss, a careful hospital preparation needs to be measured. The objective of this research was to explore the AI referral hospital resource capacity in Jakarta to cope with AI pandemic. The hospitals involved in this resource capacity study were Dr. Sulianti Saroso Infectious Hospital, Persahabatan Hospital, and GatotSoebroto Hospital. This cross sectional research aimed at measuring the capacity of the hospital beds, ICU, equipments, personal protective equipments (PPE) and drugs. The Radonovich formula was used in the calculation. The results showed that the resource capacity of the AI referral hospitals in Jakarta was limi-ted, especially in the number of ICU and non ICU beds, PPE, oseltamivir antiviral, amoxicillin and normal saline if AI pandemic occurred in Jakarta. In orderto increase the capacity of Jakarta for pandemic influenza preparedness, it is suggested to assign more hospitals for AI in Jakarta to consider the data of this research and the scenario planning approach.Key words: Avian influenza, pandemic, resources, referral hospital

Pengembangan Instrumen Sumber Daya Rumah Sakit dengan Pendekatan Systematic Review Terintegrasi Manajemen Bencana dan Pandemi Influenza Agus Suwandono; Wiku Adisasmito; Dewi Nur Aisyah
Jurnal Kesehatan Masyarakat Nasional Vol. 5 No. 6 Juni 2011
Publisher : Faculty of Public Health Universitas Indonesia

Pandemi influenza yang terjadi sejak tahun 2009 dan berbagai kejadian bencana karena kondisi geografis Indonesia membutuhkan integrasi komponen sumber daya rumah sakit terintegrasi untuk mengatasi bencana. Penelitian ini bertujuan untuk mengembangkan instrumen sumber dayarumah sakit menggunakan data Riset Fasilitas Kesehatan (Risfaskes) 2011 yang memuat komponen terkait manajemen bencana dan pandemi influenza. Instrumen ini dikembangkan dengan prinsip Client Oriented Research Activity, studi literatur serta diskusi pakar dan tim ahli di tingkat lokal dan nasional. Instrumen ini kemudian diintegrasikan ke dalam manajemen bencana dan pandemi influenza dengan pendekatan systematic review. Dalam integrasi ini, instrumen asli mengalami beberapa modifikasimenghasilkan 49 halaman instrumen rumah sakit yang komprehensif. Instrumen terintegrasi ini dapat digunakan untuk mengamati indeks kinerja rumah sakit yang hasil analisis dan simulasinya bermanfaat untuk meningkatkan perencanaan dan kesiapsiagaan menghadapi bencana danpandemi influenza di Indonesia. Kata kunci: Pandemik influenza, instrumen, sumber daya rumah sakit, systematic reviewAbstractThe rise of influenza pandemic since 2009 and various disasters prevalence in Indonesia due to its geographical condition call for an instrument designed for integrated registry of hospital resources required for overcomingthe disasters. The aim of this research was to develop an instrument of hospital resources registry using Health Facility Research (Risfaskes) 2011 data which contains components related to disaster management and influenza pandemic. The instrument was developed using Client Oriented Research Activity principles, literature study, and discussion with international and national experts. This instrument was further integrated into disaster management and influenza pandemic using systematic review approach. In this integration, several modifications to the original instrument were made resulting in a comprehensive 49 page hospital instrument. The integrated instrument can be employed to observe hospital’s performance index, from which the analysis and simulation results will also contribute to the improvement of disaster and influenza pandemic planning and preparedness in Indonesia.Key words: Influenza pandemic, instrument, hospital resource, systematic review

Hospital Readiness for Covid 19 Pandemic in Bekasi District Hospital Arda Yunita; Wiku Bakti Bawono Adisasmito
Jurnal Kesehatan Masyarakat Indonesia Volume 17. No. 1. Tahun 2022
Publisher : Universitas Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/jkmi.17.1.2022.18-24

Background: In the beginning of Covid-19 pandemic, most of hospitals were unplanned to handle this pandemic. The purpose of this study’s are to analyze the hospital readiness to cope with pandemic circumstances by evaluating hospital strategies as well as action which implement by the hospital. Methods: The study employs a method approach that includes both mix quantitative and qualitative methods. Quantitative design use main data while score and percentage as an outcome of response from checklist based on WHO Rapid Hospital Readiness as a quantitative study supported with qualitative study by in-depth interview utilize response from 12 different components on the checklist. Measurement of Hospital Readiness was carried out in Bekasi District Hospital and responses were obtained three times within seven months duration. Results: The results are as follows, first period as a baseline data in December 2020, the average score assessed is 69%, second period were taken on April 2021 average score slightly improve to 81% and the last period in July 2021 result increased to 90%. In the last period among other component, Component 10 have the lowest percentages (60%). By accomplishing the strategy for each period and continuously evaluated, the score or percentage by assessment of surge capacity readiness due to the Covid-19 pandemic has increased in Bekasi District Hospital, indicating the hospital is more ready to deal with surge capacity, and hospital perseverance is good enough. Conclusion: The checklist of the hospital readiness can be used as a baseline and a tool for hospital and health facilities evaluation.

Analisis Kebijakan Pemanfaatan Dana Kapitasi JKN pada FKTP Puskesmas di Kabupaten Bogor Tahun 2016 Abdul Gani Hasan; Wiku B.B. Adisasmito
Jurnal Kebijakan Kesehatan Indonesia Vol 6, No 3 (2017)
Publisher : Center for Health Policy and Management

AbstractBackground: The purpose of analyzing the policy of utilization of JKN capitation fund at FKTP Puskesmas in Bogor Regency refers to Permenkes 21 year 2016. Method: Qualitative with Rapid Assessment Procedure, in-depth interview on 12 informant, purposive sample, related to research objectives. Results: There is a high disparity of capitation funds for puskesmas covering participants, capitation norms, number of doctors and the ratio of doctors between various puskesmas. In-depth interviews found the difficulty of fulfilling the ideal physician ratio, low capitation norms indicated the low quality of the puskesmas, not all the puskesmas did the proper planning process, the small capitation clinics were difficult in the operational and the overwhelming operational and potentially piled up, Drug fulfillment is constrained by procurement, the potential for overlapping capitation with BOK and the quality of physician services decreases in the ratio of physicians per large participant. Conclusions and suggestions: The ratio of physicians to participants is still below the standard of 1: 5000 participants need equalization effort, 60% capitation portion for services and 40% other opersional, different sufficiency there should be operational fund backups for the less, the disincentives of service need to be reviewed, Capitation of 40% portion can be complementary with BOK, the rest of the budget is advantageous if the activity alternative can be effectively efficient according to society requirement, need improvement of drug procurement mechanism, budget flexibility need to be pushed PPK-BLUD at puskesmas.Keywords: capitation; FKTP; PuskesmasAbstrakLatar Belakang : Tujuan menganalisis kebijakan pemanfaatan dana kapitasi JKN pada FKTP Puskesmas di Kabupaten Bogor mengacu Permenkes 21 tahun 2016. Metode : Kualitatif dengan Rapid Assesment Procedure, wawancara mendalam pada 12 informan, sampel purposive, terkait tujuan penelitian. Hasil : Terdapat disparitas tinggi dana kapitasi puskesmas meliputi peserta, norma kapitasi, jumlah dokter dan rasio dokter antara berbagai puskesmas. Wawancara mendalam didapatkan sulitnya pemenuhan rasio dokter ideal, norma kapitasi rendah menunjukkan kuantitas kualitas puskesmas rendah, belum semua puskesmas melakukan proses perencanaan dengan benar, puskesmas kapitasi kecil sulit dalam operasional dan yang besar berlebih operasional dan berpotensi menumpuk, penentuan poin cukup jauh berbeda antar tenaga, pemenuhan obat-obatan terkendala oleh pengadaan, potensi overlapping kapitasi dengan BOK dan kualitas pelayanan dokter menurun pada rasio dokter per peserta besar. Kesimpulan dan saran : Rasio dokter dengan peserta masih dibawah standar 1:5000 peserta perlu upaya pemerataan, porsi kapitasi 60% untuk Jasa dan 40% opersional lain, ketercukupannya berbeda perlu ada backup dana operasional untuk yang kurang, adanya disinsentif jasa pelayanan perlu dikaji ulang, kapitasi porsi 40% dapat komplementer dengan BOK, sisa anggaran menguntungkan bila alternatif kegiatan mampu efektif efisien sesuai kebutuhan masyarakat, perlu perbaikan mekanisme pengadaan obat, dalam fleksibilitas anggaran perlu didorong PPK- BLUD pada puskesmas.Kata kunci : kapitasi; FKTP; Puskesmas

Optimalisasi Telemedicine Untuk Menegakkan Diagnosis Sebagai Inovasi Pelayanan Rumah Sakit selama Pandemi COVID-19: Tinjauan Sistematis Selly Gloria Lengkong; Wiku Bakti Bawono Adisasmito
Jurnal Kesehatan Vokasional Vol 7, No 2 (2022): Mei
Publisher : Sekolah Vokasi Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkesvo.67586

Latar Belakang: Telemedicine menurut WHO adalah pemberian pelayanan kesehatan yang dipengaruhi oleh jarak sebagai faktor utama, yang dilakukan oleh tenaga kesehatan profesional dengan menggunakan teknologi informasi dan komunikasi sebagai media pertukaran informasi yang valid untuk diagnosis, tatalaksana dan pencegahan penyakit, dan sebagai pengetahuan berkelanjutan pelayanan kesehatan. Pandemi COVID-19 menuntut rumah sakit untuk beradaptasi dengan perubahan sehingga rumah sakit mampu bersaing untuk meningkatkan kualitas hidup pasien walaupun pemeriksaan dilakukan dari jarak jauh.Tujuan: Mengetahui perkembangan penggunaan telemedicine di rumah sakit, baik dengan aplikasi maupun alat-alat atau perangkat yang dapat digunakan untuk menegakkan diagnosis pasien dari jarak jauh, untuk menjadi inovasi pelayanan rumah sakit selama pandemi COVID-19.Metode: Pencarian literatur dilakukan dengan menggunakan metode PRISMA dari 2 basis data. Artikel yang digunakan terbatas pada tahun 2017-2021.Hasil: Konsultasi, baik melalui telepon audio maupun video melalui telemedicine, masih merupakan bagian besar dari penegakkan diagnosis. Perkembangan teknologi memungkinkan rumah sakit untuk memberikan pelayanan jarak jauh dengan ditemukannya alat-alat untuk melakukan pemeriksaan fisik, skrining kegawatdaruratan pasien, dan aplikasi untuk menegakkan diagnosis pada pasien.Kesimpulan: Telemedicine dapat dioptimalisasi sebagai alat untuk menegakkan diagnosis seiring dengan perkembangan teknologi. Rumah sakit harus mengembangkan inovasi pelayanannya untuk memberikan pelayanan yang terbaik demi meningkatkan kualitas hidup pasien walaupun pelayanan tersebut dilakukan dari jarak jauh selama pandemi COVID-19.

Peran Serta Rumah Sakit Khusus Gigi dan Mulut Selama Masa Pandemi Covid-19 Novalino Novalino; Wiku Bakti Bawono Adisasmito
Jurnal Health Sains Vol. 2 No. 8 (2021): Jurnal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v2i8.251

The COVID-19 pandemic, which has occurred for almost 2 years, has infected more than 200 countries in the world, has made hospital conditions change the service strategy provided. Services that are usually provided during normal times, must change conditions starting from screening patients on arrival until the service ends. When referral hospitals are trying to save patients infected with COVID-19, other hospitals, especially dental and oral hospitals, also participate in removing this nation from the grip of the COVID-19 pandemic, although they do not directly treat COVID-19 patients. By using descriptive qualitative research methods, researchers can obtain deeper information from a case study at a special dental and oral hospital, which usually only provides dental services. The purpose of this study was to get an overview of the efforts made by dental and oral hospitals in providing services to the community in an effort to break the chain of transmission of COVID-19. The results obtained are an evaluation of the increase in the number of patients and dental emergency room services, the implementation of tracing and testing for all hospitalians, as well as providing vaccination services, which are things that special dental and oral hospitals can do in participating in taking part and breaking the chain of transmission of COVID-19.

Gambaran Umum Faktor Risiko Covid-19 pada Tenaga Kesehatan Rumah Sakit di Asia Narizma Nova; Wiku Bakti Bawono Adisasmito
Jurnal Health Sains Vol. 2 No. 8 (2021): Jurnal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v2i8.258

In 2020, nearly 300,000 health workers who were infected and died due to Covid-19 around the world including Asia. Several countries in Asia are among the top 10 of the highest healthcare workers deaths in the world. When the rate of infection and hospitalization increases, health workers must be prioritized so that they are not drained by the Covid-19 infection. Health workers are at a high risk level for exposure to the Covid-19 while they hold an important roles of handling the Covid-19 case. This systematic review aims to analyze the risk factors of health workers in hospitals among Asian Countries regarding Covid-19. We searched, from Science Direct, Springerlink and Pubmed identify relevant studies from 2020 on the topic of risk factors of transmission Covid-19 among healthcare workers in hospital of Asian Countries. From these searches, a total of 135 papers were identified of which 22 studies met criteria. The main results were about risk factors for health workers in hospitals during Covid-19 such as personal protective equipment (PPE) availability, exposure to infected patients, excessive workload, IPC training, pre-existing medical conditions and psychological factors. The level of knowledge of health workers about Covid-19 is classified as good, but factors such as job categories, work experience affect their attitudes and behavior so that the factors of anxiety, fatigue and stress are quite varied. It takes considerable efforts and strategies especially from the work place so that the risk factors from health workers can be overcome.

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