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Faktor yang Mempengaruhi Cakupan Layanan Farmasi di Instalasi Rawat Jalan Rumah Sakit Herjunianto, Herjunianto; Wardhani, Viera; Prihastuty, Jany
Jurnal Kedokteran Brawijaya Vol 28, No 1 (2014)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Cakupan layanan farmasi merupakan indikator penting mutu layanan dan mempengaruhi pendapatan rumah sakit. Penelitian ini bertujuan untuk mencari akar masalah pembelian resep instalasi rawat jalan di farmasi (pharmacy coverage) rumah sakit yang tidak optimal. Pada penelitian ini dilakukan identifikasi alur pelayanan rawat jalan dan farmasi serta potensi permasalahan sebagai dasar dalam mengidentifikasi akar masalah melalui observasi, ghost shopping, wawancara dan survei harga obat. Penentuan akar masalah menggunakan metode â€œ5 Whysâ€. Akar masalah pengambilan resep obat di farmasi tidak optimal antara lain karena keterlambatan praktek dokter, kurangnya komunikasi perawat maupun petugas farmasi kepada pasien, sistem administrasi dan informasi rumah sakit tidak real time, kurangnya sarana penunjang dan pengalih perhatian pasien saat menunggu yang mempengaruhi persepsi waktu tunggu. Meskipun waktu aktual yang dibutuhkan untuk mendapatkan layanan di rawat jalan masih sesuai Standar Pelayanan Minimal Rumah Sakit, namun seringkali pasien menilai lama dalam menunggu untuk mendapatkan layanan sehingga tidak puas. Hal ini dimungkinkan karena adanya perbedaan antara harapan dan kenyataan layanan yang diterima. Pengelolaan persepsi waktu tunggu dapat menjadi kunci bagi rumah sakit untuk meningkatkan cakupan layanan farmasi.Kata Kunci: Instalasi rawat jalan, pelayanan farmasi, waktu tunggu

PENGARUH GAYA BERENANG (GAYA BEBAS DAN GAYA DADA) TERHADAP PERUBAHAN VOLUME OKSIGEN MAKSIMUM Dennison, Dennison; Sriwahyuni, Endang; Wardhani, Viera
Jurnal Kedokteran Brawijaya Vol 19, No 2 (2003)
Publisher : Fakultas Kedokteran Universitas Brawijaya

ABSTRACT SwimmingÂ isÂ frequentlyÂ usedÂ toÂ improveÂ theÂ individualÂ physicalÂ endurance.Â MostÂ ofÂ theÂ studiesÂ haveÂ provedÂ thatÂ swimmingÂ can improve the maximum oxygen volume effectively, but none of them compare the differences in the swimming styles. The study was aimed to analyse the differences of swimming styles in improving maximum oxygen volume, so it can be used as basis for physical training scheme. A pretest-posttest experimental design was conducted in two sample groupÂ (front crawl stroke group and breast strokeÂ group)Â consistsÂ ofÂ sixÂ peopleÂ inÂ eachÂ group.Â TheÂ samplesÂ wereÂ selectedÂ basedÂ onÂ questionaireÂ toÂ controlÂ theÂ confounding variables, ie: sex, age, height, weight, training habit and health status (anemia, heart disease and respiratory distress). The training method were carried out in 12 session in 4 weeks (3 session per week) by increasing the swimming distance gradually. Each session arrangement was consists of warming up - training in short sets with rests - relaxation. The maximum oxygen volume was measured using Cooper method and the result was analyzed using independent sample t-test with SPSS 11. The result shows that there is a significant difference in maximum oxygen volume improvementÂ (t= -4.718, CI 95% = lower: -5.014; upper: -1.722, p= 0.002) in which the result in breast stroke group hasÂ a higher improvement (mean: 6.313, sd: 1.378)

Akurasi Fibrinogen dan Hs-CRP sebagai Biomarker pada Sindroma Koroner Akut Setiawan, Ivan; Wardhani, Viera; Sargowo, Djanggan
Jurnal Kedokteran Brawijaya Vol 26, No 4 (2011)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Peran fibrinogen dan Hs-CRP menunjukkan potensinya sebagai biomarker pada sindrom koroner akut. Penelitian ini adalah observasional dengan pendekatan potong lintang yang berlangsung dari bulan Februari dampai dengan Juli 2011. Jumlah subjek untuk tiap kelompok kasus maupun kontrol adalah 76, berusia antara 35 sampai dengan 80 tahun. Kedua kelompok diukur kadar fibrinogen dan Hs-CRP. Cut off masing-masing biomarker diukur dengan Receiver Operating Curve. Akurasi dr nilai diukur dengan sensitivitas, spesifitas, rasio kemungkinan, nilai duga positif dan nilai duga negatif, baik secara kombinasi maupun terpisah. Umur rerata pada kedua kelompok 57,5 tahun. Kadar fibrinogen pada kelompok kasus (5,8Â±1,56 g/L) berbeda bermakna dibandingkan dengan kelompok kontrol (3,78Â±1,78 g/L). Kadar Hs-CRP pada kelompok kasus (4,04Â±1,94 mg/L) berbeda bermakna dibanding kelompok kontrol (1,98Â±1,25 mg/L). Kedua biomarker baik secra kombinasi atau terpisah dapat dipakai sebagai alat diagnostik pada sindrom koroner akut. Fibrinogen dan Hs-CRP mempunyai nilai diagnostik terbaik dibanding bila digunakan secara terpisah.Kata Kunci: Atherosklerosis, biomarker, fibrinogen, Hs-CRP, inflamasi, sindrom koroner akut

Penggunaan Suksinilkolin Setelah Tidak Meningkatkan Kadar Kalium Plasma Pasien dengan Cedera Kepala Berat Purwati, Wahyuni Dian; Wardhani, Viera; Mahameru, Gunung; Istiadjid, Mohamad
Jurnal Kedokteran Brawijaya Vol 25, No 2 (2009)
Publisher : Fakultas Kedokteran Universitas Brawijaya

This study aimed to identify the changes of plasma potassium level after intubation with rapid sequenceintubation method in severe head injury patients using succinylcholine as muscle relaxant. Subjects aresevere head injury patients with glasgow coma scale (GCS) â‰¤ 8. Plasma potassium level was measured twice,before intubation and (minutes 5, 10, 15, 20) after intubation. Another variable that also measured were bloodgas analyze, time intubated and injury in another organ. There were 34 patients who came to EmergencyDepartment (ED) of Saiful Anwar General Hospital since January until April 2009. Mean level of plasmapotassium changes after intubation minute 5 (-0.01529); minute 10 (-0.01971); minute 15 (0.04147); minute20 (0.00059). Statistical analysis using paired t test revealed no significance of this difference (p>0.05). Therewere no changes of plasma potassium level in severe head injury patients after intubation withsuccinylcholine

Aromaterapi Bunga Lavender Memperbaiki Kualitas Tidur pada Lansia Kurnia, Anggraini Dwi; Wardhani, Viera; Rusca, Kuswantoro Tri
Jurnal Kedokteran Brawijaya Vol 25, No 2 (2009)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Sleep is a basic human need, characterized by minimal physical activity, change in physiological process ofthe body and decrease respon from external stimulus. Most of the elderly have high risk to suffer sleepproblem because of some factors. Aromatherapy is a therapy using essential oil which produces comfortableeffect, more steady emotion and feeling, calmer thought and feeling. This research was aimed to identify theeffectivity of Lavender (Lavendula L) Aromatherapy in improving quality of sleep of the elderly in Panti WerdhaMalang. A quasi experiment study was implemented with randomized control group pretest posttest using 18subjects divided into two groups.and treatment. The sleep quality was measured by interview developedbased on PSQI (Pittsburgh Sleep Quality Index). The data were then analyzed using Wilcoxon test and Mann-Whitney test. A significant improvement of sleep quality score was identified in treatment group (3,89, p=0,07) but not in the control group (0,78;p=0,317). These improvement is significantly different between the twogroups (p=.0,001). It can be concluded that Lavender aromatherapy is significantly improve the quality ofsleep in elderly people

The Meaning of Breast Cancer Patientsâ€™ Experience in Hospital X: a Viewpoint From Patient Centered Care Rozany, Farida; Winarni, Indah; Wardhani, Viera
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 8, No 2 (2019): August
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.8299

Patient experience is a significant factor in improving hospital service quality. This study aims to determine the meaning of treatment received by breast cancer patients during the treatment period. In the treatment of breast cancer, the patients require a personalized service or patient-centered care. This research is a qualitative analysis with phenomenology approach. Informants in this study were breast cancer patients who underwent chemotherapy treatment and had a mastectomy. Data were obtained through in-depth interviews in patients with breast cancer. The results of the study revealed there are 10 themes, namely worrying about something uncomfortable in the body, resigning to the doctor's recommendations, feeling comfortable and uncomfortable in the service received, feeling stress after recognizing the disease suffered, feeling fearful to the disease, experiencing pain before and after treatment, obtaining encouragement, refraining from thinking that slows down the healing, feeling of having no choice over the disease, and feeling of not obtaining Â explanation. There is relevance between theme and patient-centered care.

Laboratory Service Process Checklist: Preventive Measures to Increase Blood Glucose Test Accuracy Setyawan, Yudi; Wardhani, Viera
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar

The accuracy of the blood glucose test results is an important measure for hospital quality due to its effect on treatment plan, decision and outcome. This study aims to develop checklists model to improve the laboratory results accuracy. The development of the checklist was based on laboratory services process: pre-analytic, analytic, and post-analytic which further implemented for all requests for blood glucose tests during study period (65 examination) in the first week of October 2020. After the implementation, result showed no incidence of test in-accuracy when conformed with patient clinical information. Staff express that the checklist is fast and easy to complete (3-5 minutes), and beneficial. Problem occurs when the workload is high because of limited number of staff at night shift or high patient volume leading to delay in checklist completeness. Therefore, regular monitoring and evaluation was suggested to ensure compliance, in addition to dividing the checklist performed in 2 stages. The pre-analytic stage is carried out first for all patients followed by the analytical and post-analytic stages because these two activities were located in different floor. It can be concluded that the use of checklists is effective as preventive measure increase the conformity of laboratory examination results with patient clinical information.Keywords: Laboratory checklist, test accuracy, patient safety.

Completeness of Medical Record Documents: Exploration of Causes and Solutions Syukria, Orin Annahriyah; Wardhani, Viera
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar

One of the problems identified at X Hospital in the first six months of 2020 was the delay in returning inpatient medical records to the medical records unit. This study was conducted to explore the elements of the incomplete medical records and the factors that contribute to the emergence of delays in returning these documents. This study uses a qualitative method. Exploration was carried out on 21 medical records using a checklist. Besides, data were obtained through interviews involving the head of the relevant unit and a survey of 52 nurses. Data were collected using interview guidelines and nursing work index-revised (NWI-R) instruments. Incompleteness was found mostly in the patient discharge summary form, initial emergency assessment, and initial inpatient medical assessment. Items that have not been completed at most are officer authentication and information on date and time. One of the root causes of this problem is the factor of the nurse. The results of the NWI-R assessment are 3.15 (maximum value 4), which means that the work environment at X Hospital supports nurses in carrying out their duties well. The highest score is 3.31 on the nurse-doctor relationship factor. The lowest score is 2.93 on adequate human resources to ensure quality services.

The Effectiveness of Giving Cognitive Behavior Therapy (CBT) and Mindfulness Therapy on Adolescents' Social Anxiety Levels Sukmawati, Yulia; Lestari, Retno; Wardhani, Viera
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 8, No 1: March 2023
Publisher : Universitas Aisyah Pringsewu

Social anxiety is a serious problem occurring in early adolescence characterized by a high level of worry, negative evaluation, and avoidance behavior in various social situations. The existence of fear, worry, and unconsciousness in recognizing negative thoughts that cause avoidance in adolescents with social anxiety problems can be overcome by providing CBT and Mindfulness therapy. This study aims to identify the effectiveness of Cognitive Behavior Therapy (CBT) and mindfulness therapy on adolescent social anxiety problems. this research is a research quasi-experimental pre-test post-test control group design. There were 40 participants in this study, namely 20 students in the control group and 20 students in the treatment group. The results obtained from this study were that there were differences in the effectiveness of giving CBT with a combination of CBT and mindfulness in adolescent social anxiety with a p-value of 0.002 (0.002 less than 0.05) which was marked by a decrease in the average score of social anxiety in the group given the CBT combination intervention and mindfulness were greater compared to adolescents who were only given CBT. So it can be concluded that the effectiveness of giving a combination of CBT and mindfulness is better than giving CBT to adolescents who experience social anxiety problems. Abstrak: Kecemasan sosial merupakan masalah serius terjadi pada usia remaja awal ditandai dengan tingkat kekhawatiran tinggi evaluasi negatif dan perilaku penghindaran dalam berbagai situasi sosial. Adanya ketakutan, kekhawatiran serta ketidak sadaran dalam mengenali pikiran negatif yang menyebabkan penghindaran pada remaja dengan masalah kecemasan sosial dapat diatasi dengan pemberian terapi CBT dan Mindfulness. Penelitian ini bertujuan untuk mengidentifikasi efektifitas pemberian Cognitive Behaviour Therapy (CBT) dan terapi mindfullness pada masalah kecemasan sosial remaja. Penelitian ini adalah penelitian quasi eksperimental pre-test post-test control group design. Terdapat 40 peserta dalam penelitian ini yaitu 20 siswa dalam kelompok kontrol dan 20 siswa dalam kelompok perlakuan. Hasil yang didapatkan dari penelitian ini adalah bahwa ada perbedaan efektifitas pemberian CBT dengan kombinasi CBT dan mindfulness terhadap kecemasan sosial remaja dengan nilai p-value 0.002 (0.002 kurang dari 0.05) yang ditandai dengan penurunan skor rata-rata kecemasan sosial pada kelompok yang diberikan intervensi kombinasi CBT dan mindfulness lebih besar dibandingkan dengan remaja yang hanya diberikan CBT saja. Sehingga dapat disimpulkan bahwa efektifitas pemberian kombinasi CBT dan mindfulness lebih baik dibandingkan dengan pemberian CBT pada remaja yang mengalami masalah kecemasan sosial.

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