Faiqatul Hikmah
Program Studi D IV Rekam Medik, Jurusan Kesehatan, Politeknk Negeri Jember

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Penentu Prioritas Dan Perbaikan Masalah Keterlambatan Pengembalian Berkas Rekam Medis Rawat Inap DI RSD Kalisat Faiqatul Hikmah; Rosalina Adi Wijayantin; Yonica Putra Rahmadtullah
Jurnal Manajemen Informasi Kesehatan Indonesia (JMIKI) Vol 7, No 1 (2019)
Publisher : Asosiasi Perguruan Tinggi Rekam Medis dan Informasi Kesehatan Indonesia- APTIRMIKI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33560/jmiki.v7i1.214

Abstract

Kegiatan pengembalian berkas rekam medis pasien rawat inap memiliki standar waktu pengembalian 2x24 jam setelah pasien pulang sesuai dengan SOP yang berlaku di rumah sakit. Namun keterlambatan pengembalian berkas rekam medis di RSD Kalisat masih sering terjadi. Tujuan dari penelitian ini adalah melakukan penentuan prioritas dan perbaikan masalah keterlambatan pengembalian berkas rekam medis rawat inap di RSD Kalisat. Jenis penelitian ini adalah penelitian kualitatif deskriptif dengan metode pengumpulan data wawancara, dokumentasi, dan brainstorming. Hasil identifikasi faktor-faktor penyebab keterlambatan berkas rekam medis menyatakan bahwa keterlambatan pengembalian berkas rekam medis disebabkan oleh beberapa hal salah satunya yaitu ketidaklengkapan pengisian berkas rekam medis. Perencanaan yang dilakukan pada penelitian ini adalah perbaikan Standart Oprasional Prosedur Evaluasi Kelengkapan Pengisian Berkas Rekam Medis yang berertujuan untuk menunjang kualitas berkas dalam kelengkapan pengisian berkas rekam medis dan untuk mempermudah administrasi pengembalian berkas. Dari hasil penelitian ini peneliti menyarankan agar adanya pelatihan tentang pengembalian berkas berkas terhadap petugas rawat inap. Perlu juga adanya penerapan standart oprasional prosedur untuk mempecepat waktu melengkapi pengisian berkas rekam medis dan dapat dilakukan peninjauan terus menerus hal ini bertujuan sebagai pengingat agar berkas rekam medis bisa segera dilengkapi dan bisa kembali sesuai dengan batas waktu yang telah ditentukan.
PEMBUATAN WEBGIS PENYAKIT INFEKSI SALURAN PERNAFASAN AKUT (ISPA) DI KABUPATEN JEMBER TAHUN 2013-2015 (THE MANUFACTURE OF WEBGIS FOR ACUTE RESPIRATORY TRACT INFECTIONS (ARI) IN JEMBER REGENCY IN 2013-2015 Sustin Farlinda; Faiqatul Hikmah; Fahrur Rozi
Jurnal Manajemen Informasi Kesehatan Indonesia (JMIKI) Vol 6, No 2 (2018)
Publisher : Asosiasi Perguruan Tinggi Rekam Medis dan Informasi Kesehatan Indonesia- APTIRMIKI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33560/.v6i2.193

Abstract

Acute Respiratory Infection (ARI) is a common disease in children. Incidence by underage age group is estimated to be 0.29 episodes per child / year in developing countries and 0.05 episodes per child / year in developed countries. Jember Regency Health Office placed ISPA as the top 15 most diseases in Jember Regency, occupying the first position in the highest disease sequence. This study aims to create a WebGIS mapping of ISPA disease to determine the spread of ARI and determine the priority areas of anticipatory and prevention programs of ARI in Jember Regency. The design method uses a waterfall diagram that includes analysis, design, coding, and testing. The result of this research is a WebGIS of Acute Respiratory Infection Disease in Jember Regency in 2013-2015. This digital map has a color that can define the number of ARI events seen from the incidence of ARI cases in each region in Jember Regency, and displays information in each sub-district related to disease info, number of patients and other supporting data. The data analysis showed the highest ARI occurrence in Jenggawah district, Sumberbaru district, Rambipuji district, and Bangsalsari district during 2013-2015.
KETERISIAN DAN KEAKURATAN PENULISAN KODE ICD-10 (INTERNATIONAL STATISTICAL CLASSIFICATION OF DISEASES AND RELATED HELATH PROBLEM TENTH REVISION) TERHADAP DIAGNOSIS UTAMA DI POLI BEDAH RUMAH SAKIT BAPTIS BATU Faiqatul Hikmah; Rosalina Adi Wijayantin; Yonica Putra Rahmadtullah
Jurnal Manajemen Informasi Kesehatan Indonesia (JMIKI) Vol 1, No 2 (2013)
Publisher : Asosiasi Perguruan Tinggi Rekam Medis dan Informasi Kesehatan Indonesia- APTIRMIKI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33560/.v1i2.52

Abstract

ABSTRACKThe hospital is a center of important information about health. As an information center, the hospital is expected to provide precise and accurate information. The accuracy of diagnosis coding akam disease patients are very influential in many respects, therefore, necessary writing diagnosais complete and correct disease, so as to facilitate the process codefication diagnosis based on ICD-10 disease. Researchers want to know more about the completeness and accuracy of disease diagnosis codefication by ICD-10 in Poly Stone Baptist Saki surgical house. The study was conducted in Inpatient Surgical Care and Medical Record Part Stone Baptist Hospital. This type of research is conducted by researchers dekskriptif is by analyzing the data and presenting the facts in a systematic way so that it can be easier to understand.Method used is the method of observation with Cross-Sectional approach. Observations made on the document Inpatient medical records of surgical patients Baptist Hospital Rock in January-March of 2013. From the results of a study of 71 data, the occupancy number of diagnoses and ICD-10 code medical records document the period January-March 2013 Inpatient Surgical Care RSBB complete the calculation in January 16 document medical records, February 29, and March 26, full-filled with a percentage of 100%, while the diagnosis is incomplete or not filled with as much as 0 percent 0% sample. Number of ICD-10 codes inaccuracies highest in January is by percentage of 19%, then in the second position in February with the percentage of 17% and 12% in March. There were five major diseases diagosis first quarter of 2013 in the Inpatient Surgical Poly Ca mammary RSBB is 15%, 13% inguinal hernia, acute appendicitis 11%, Multiple soft tissue lipomas 8%, 3% Benign mammary dysplasia.From the comparison of the percentages can be seen that charging the diagnosis of diseases in Poly Stone Baptist Hospital Surgical already filled out completely, but there are still some code that does not accurately diagnose illness. Factors affecting disease diagnosis inaccuracies codefication not entirely influenced by knowledge of medical officers and officers in the medical record coding, but also accuracy in recording. Therefore there needs to be an agreement of physicians, nurses poly, and personnel records medi sdalam writing code diagnosis and disease diagnosis charging properly, resulting in a diagnosis code is appropriate and accurate.Keyword: OCCUPANCY, ACCURACY, ICD-10, DIAGNOSIS OF MAJOR SURGERY
ANALISIS KUALITATIF DOKUMEN REKAM MEDIS RAWAT INAP DIARE AKUT BALITA DI RUMAHSAKITISLAMMASYITHOH BANGIL KABUPATEN PASURUAN TAHUN 2016 Faiqatul Hikmah; Rossalina Adi Wijayanti; Nur Hidayah
Jurnal Manajemen Informasi Kesehatan Indonesia (JMIKI) Vol 6, No 2 (2018)
Publisher : Asosiasi Perguruan Tinggi Rekam Medis dan Informasi Kesehatan Indonesia- APTIRMIKI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33560/.v6i2.194

Abstract

Acute diarrhea is on the first rank of 10 major diseases at the inpatient installation of RSI Masyithoh Bangil Pasuruan in 2015and also on the second rank in 2014. The problems that occur are the low completeness and consistency of medical record document of toddler’s acute diarrhea at RSI Masyithoh Bangil Pasuruan in 2016. The purpose of this research is to analyze the qualitative document of hospitalization medical record on toddler’s acute diarrhea at RSI Masyithoh Bangil Pasuruan in 2016. The type of this research is qualitative research and data collection technique used are observation, interview, and documentation. The population in this research was 272 DRM toddler’s acute diarrhea, with the total sample of 82 DRM. The results of this research are, incompatibilities and incompleteness of DRM toddler’s acute diarrhea at RSI Masyithoh Bangil Pasuruan especially in terms of qualitative medical history, physical examination, action or therapy, and home status. Utilization of extra information is recorded correctly. Health personnel are advised to complete DRM immediately after completion of the action or examination. And the need to do evaluation in improving the quality of inpatient medical records, especially on toddler’s acute diarrhea is in the completeness and consistency of qualitative data on medical record documents.