Ida Bagus Nyoman Maharjana
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PREVENTION AND MANAGEMENT FOR THE COMPLICATION OF THIRD MOLAR SURGERY : A SYSTEMATIC REVIEW Ida Ayu Wirastuti; Ida Bagus Nyoman Maharjana; Prastuti Soewondo
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Impacted third molar surgery is one of the most common procedures performed by maxillofacial surgeons and it is often attended by complications. Although clinical conditions associated with retained third molars are well understood, little is known about the impact of those conditions on the quality of life among affected patients. There is growing recognition that the impact of oral conditions on quality of life is an important outcome that can be quite useful in making treatment decisions. All the information in this review could be useful for the clinicians in order to show the surgical and pharmacologic parameters that may influence the postoperative discomfort in the third molar surgeries. Methods: This systematic review followed the recommendations in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Some of the key words or Medical Subject Heading (MeSH) terms used in in the two data bases (Proquest and Google Scholar) were: (1) Third Molar Surgery, (2) Complication, (3) Prevention. The articles were published in English from 2009 to 2019. Results: Studies were eligible if they evaluated prevention and management for the complication of third molar surgery, and eight studies for qualitative synthesis. Of the eight articles, all studies were selected with Randomized Control Trial. Eight studies were included because they discussed the prevention and management of third molar surgery complication. Almost all of the practices of prevention and management of third molar surgery complication described that analgetic ibuprofen and paracetamol were used for decreasing the pain, and also amoxicillin tablet was used as an antibiotic for preventing high risk complication. According to studies, prophylactic use of chlorhexidine mouth rinse in third molar surgery are equally effective in keeping post operative infection to a minimum level in medically competent patient. Conclusions: All studies revealed that the most common complications of third molar surgery were pain, trismus, swelling, alveolar osteitis, and dry socket. Those studies discussed the prevention and management third molar surgery complication. Ibuprofen and paracetamol were used to decrease the pain, amoxicillin (1g) and amoxicillin/clavulanate (875/125mg) had similar efficacious in preventing infection after retained third molar extraction, but amoxicillin and clavunate (875/125mg) produced more gastrointestinal discomfort. Prophylactic use of chlorhexidine mouth rinse and gel in third molar surgery were equally effective in keeping post operative infection. Corticosteroid had a significant and sustained anti- inflammatory effects.
ANTIMICROBIAL STEWARDSHIP STRATEGY TO REDUCE LENGTH OF STAY AND COST OF ANTIBIOTIC CONSUMPTION: A SYSTEMATIC REVIEW Anak Agung Istri Agung Sri Stuti Damayan; Ida Bagus Nyoman Maharjana; Atik Nurwahyuni
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Reducing the cost of care and length of stay for patient in hospital are important to monitor the benefits of implementing an antimicrobial management program. An antimicrobial management program is a strategy to decrease Antimicrobial Resistance (AMR) that affect to the treatment of the patient. One of the antimicrobial management programs is Antimicrobial Stewardship Programs (ASP). This study aims to determine the appropriate strategies in the application of Antimicrobial Stewardship Programs (ASP) that can reduce the length of stay and cost of antibiotic consumption for patient in hospital.Methods: This study was a systematic review that used PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Data obtained from Electronic databases ProQuest and Medline (PubMed) that published five years times span. By using keywords such as antimicrobial stewardship, antimicrobial resistance, length of stay, length of the hospital and patient cost to find the relevant journal. Results:  The search found 3,541 studies, of which 26 studies were included in the systematic review. After excluded the article review, there were 9 studies that used quasi-experimental, observational cohort studies and Randomized Control Trial (RCT). These studies conducted majority in Europe and USA, only 1 study that conducted in Asia. Analysis of the studies found out that 6 of 9 studies mentioned if ASP can reduce the length of stay of the patient in hospital. Only 3 of 9 studies that examined the effect of ASP in cost of care and these 3 studies mentioned ASP can reduce the cost of care. Conclusion: This study showed that implementing ASP can reduced the length of stay and antibiotics consumption among patient in hospital by manage the antimicrobial use, conduct audits and feedback in an appropriate step, and intravenous to oral switch program.
FACTORS RELATED TO THE REDUCTION OF MEDICATION DISCREPANCIES AT TRANSITION OF CARE: A SYSTEMATIC REVIEW Ida Bagus Nyoman Maharjana; Adik Wibowo
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Adverse drug events (ADE) are a leading cause of injury and death within health care systems around the world. Up to 67% of patients’ prescription medication histories recorded on admission to hospital have one or more errors and 30 – 80% of patients have a discrepancy between the medicines ordered in hospital and those they were taking at home. This study aims to systematically evaluate the available literature on the medication history records as a quality improvement in reducing medication discrepancies during the transition of care. Methods: This study was used systematic review which performed according to the PRISMA method. The search included articles were obtained through databases: MEDLINE (1946), EMBASE (1966), CINAHL (1937) and PubMed (1946). Some of the key words or Medical Subject Heading (MeSH) terms used in the search were: “transition of care,” “medication discrepancies,” “medication errors,” “patient safety,” “medication history,” “patient admission,” “patient discharge,” “patient transfer,” and “hospital”. Only studies published in English were included. Exploring literature was focused on the articles published from 2009 to 2019. Results: Initially, a total of 162 potentially relevant articles were obtained. After screening tittle and reviewing abstracts, 14 full text were assessed for eligibility. Of the 10 articles met all inclusion criteria, 5 studies were randomized controlled trials, 2 quasi-experimental studies, 1 cohort study, and 2 qualitative studies with quantitative approaches. All studies found that involving best possible medication history in identifying medication discrepancies and communicating this information affected medication discrepancies in the medical record. Conclusions: The available literature such as lack of well-designed studies precluded us from concluding that no effect exists. Medication reconciliation supported by information technology was an important tool for minimizing the percentage of medications with unintentional discrepancies