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The  Relationship Between Nurse Response Time In Treating Open Fractur Patients And The Risk Of Hypovolemic Shock In The Emergency Room Of Grandmed Hospital Lubuk Pakam Karokaro, Tati Murni; Insani Alja , Amy Vivi
JURNAL KEPERAWATAN DAN FISIOTERAPI (JKF) Vol. 8 No. 1 (2025): Jurnal Keperawatan dan Fisioterapi (JKF)
Publisher : Fakultas Keperawatan dan Fisioterapi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/kxsgpw35

Abstract

Introduction:Open fractures are bone injuries involving skin disruption, leading to direct bone exposure and a high risk of contamination. Emergency care reports indicate that around 50% of trauma patients die en route to the hospital, 35% due to severe injuries. Timely nursing response is crucial in early emergency management, especially in open fractures. This study aimed to assess the association between nurses' response time and the risk of hypovolemic shock in patients with open fractures. Methods:A descriptive correlational study was conducted from September to October 2024 at the Emergency Department of Grandmed Hospital, Lubuk Pakam. Thirty-one nurses were selected using total sampling. Data were obtained through structured observations of eligible nurses. Results: Delayed response was observed in 32.3% of nurses, with hypovolemic shock occurring in 32.3% of patients. Fisher’s Exact Test revealed a significant association between nursing response time and hypovolemic shock risk (p = 0.040). Discussion: Delayed nursing interventions were significantly linked to increased hypovolemic shock risk. The findings underscore the need for effective leadership and prompt nursing action to prevent complications.
The Influence of Inpatient Service Quality on Patients' Decisions to Go Home at Their Own Request (Paps) at The Mayjen H.A Thalib Regional Hospital, Sungai Penuh City Putri, Puji Audina; Romauli Anna Teresia Marbun; Tati Murni Karokaro
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/3nn67r29

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"Discharge at Own Request (PAPS)" is one of the indicators used to assess the quality of inpatient care services. Based on direct interviews with several PAPS patients in the inpatient ward of a particular regional public hospital (RSUD), several factors were identified as triggers for their decision to leave, including the waiting time for treatment and the condition of the treatment room and walls, which appeared uncomfortable—especially for patients who did not yet have a BPJS National Health Insurance) card.The high incidence of patients discharging themselves at their own request (PAPS) has an impact on the hospital, including a potential decrease in service efficiency, as indicated by a reduction in the length of stay (LOS). This study aims to identify and analyze the influence of inpatient service quality on the decision of patients to discharge themselves at their own request (PAPS) at RSUD Mayjen H.A. Thalib, Sungai Penuh City, in 2025.This is a quantitative study using a cross-sectional study design. The research was conducted at RSUD Mayjen H.A. Thalib, Sungai Penuh City, from November 2024 to April 2025. The sample consisted of 125 patients hospitalized in the inpatient ward of RSUD Mayjen H.A. Thalib, Sungai Penuh City. The sampling technique used was accidental sampling.The research findings indicate a correlation between patient satisfaction—based on the aspects of tangibles, reliability, Responsiveness , assurance, and empathy—and the decision to discharge themselves at their own request (PAPS) at RSUD Mayjen H.A. Thalib, Sungai Penuh City, in 2025. Therefore, it is recommended that regular training be provided to all medical personnel and hospital staff to enhance their competence and ability to deliver optimal healthcare services.
Analysis of Challenges and Barriers in the Implementation of Standard Inpatient Wards at Hospital Putra Harahap, Bahdi Mandala; Balqis Wasliati; Tati Murni Karo Karo
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/pwyksc03

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Background: RSU Wira Husada Kisaran faces challenges in implementing the Standard Inpatient Class (KRIS) in accordance with the applicable regulations. Despite planning efforts, obstacles such as the absence of a formal organizational structure, uneven distribution of medical personnel, and limited funding continue to hinder KRIS implementation. Research Objective: This study aims to analyze the current implementation of KRIS at RSU Wira Husada Kisaran, identify the existing obstacles, and explore policy alternatives to improve the incident reporting system for patient safety and the overall KRIS implementation.Research Method: This research employs a qualitative approach with Grounded Theory to uncover the factors that hinder KRIS implementation. Data was collected through interviews with hospital management, medical staff, and nursing personnel. To develop alternative policies, the study used the Analytical Hierarchy Process (AHP). Results: The results show that while the hospital has developed a KRIS plan, challenges such as uneven distribution of nurses, slow funding management, and the absence of a specific SOP for KRIS persist. The facilities and infrastructure meet most standards; however, maintenance and facility improvements still need to be enhanced. Conclusion:RSU Wira Husada Kisaran has taken steps to overcome these obstacles. However, strengthening the formal organizational structure, maintenance systems, and transparency in financial management are still necessary to improve the effectiveness of KRIS.
The analysis of the factors influencing the awareness of post-operative neurosurgery patients in the ICU of a hospital N.C Sitanggang, Margaretha; Karnirius Harefa; Tati Murni Karo Karo
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/xmqpxm81

Abstract

Background: The Intensive Care Unit (ICU) plays a crucial role in the care of post-surgical neurosurgery patients, as patients with critical conditions require close monitoring. The changes in the consciousness level of post-neurosurgery patients are influenced by various factors, including age, gender, Glasgow Coma Scale (GCS), family support, and teamwork among medical staff. Objective: This study aims to analyze the factors influencing the changes in the consciousness level of post-neurosurgery patients in the ICU of Grandmed Lubuk Pakam Hospital in 2024. Research Method: This study uses a cross-sectional design with primary data collection through observation and direct measurement. The sample consists of 40 post-surgical neurosurgery patients treated in the ICU of Grandmed Lubuk Pakam Hospital. Data were analyzed using univariate, bivariate, and multivariate analysis, employing chi-square tests and logistic regression. Results: The results show that factors such as age, gender, GCS, family support, and teamwork significantly influence the consciousness level of patients. The GCS factor (?8) has the most dominant effect, with an Odds Ratio (Exp(B)) = 5.523, indicating that patients with a low GCS have 5 times the risk of experiencing a decrease in consciousness compared to patients with a higher GCS. Conclusion: Factors such as age, gender, GCS, family support, and teamwork influence the changes in the consciousness level of post-neurosurgery patients. Monitoring GCS and strengthening teamwork, along with family support, can accelerate the recovery of patients' consciousness.
Analysis of Head Nurse Leadership Style on Nursing Service Quality in the Intensive Care Unit at the Hospital Romi Syahputra Tarigan; Karnirius Harefa; Tati Murni Karo Karo; Abdi Lestari Sitepu
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/mwqpvv54

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Background: Pneumonia is one of the leading causes of death in children under five in Indonesia. Pneumococcal Conjugate Vaccine (PCV) immunization is a preventive measure, yet coverage in Serdang Bedagai Regency remains low. Factors such as knowledge, education, occupation, attitude, belief, health service accessibility, and family support are suspected to influence PCV utilization. Research Objectives: This study aimed to analyze the factors influencing PCV immunization utilization at Sei Rampah Health Center, Serdang Bedagai Regency. Research Methods: This research employed an analytic survey with a cross-sectional design. The population consisted of 900 mothers with children aged 11–12 months, and a sample of 262 mothers was selected using simple random sampling. Data were collected through questionnaires and secondary data from PWS-KIA. Univariable, bivariate (Chi-square), and multivariable analyses (multiple logistic regression) were performed to identify the dominant factors. Results: Bivariate analysis indicated that education (p=0.002; OR=6.882), occupation (p=0.000; OR=6.088), and knowledge (p=0.000; OR=15.400) were significantly associated with PCV utilization. Multiple logistic regression revealed knowledge as the dominant factor (p=0.000; Exp(B)=13.063), followed by occupation, attitude, belief, and family support. Age, health service accessibility, and education did not show a significant effect. Conclusion: Parental knowledge is the key factor influencing PCV immunization utilization. Efforts to increase immunization coverage should focus on continuous education by health workers and family involvement to improve parents’ awareness and compliance with child immunization schedules.
Persepsi dan Hambatan Orang Tua dalam Mengikuti Program Pendidikan Pengelolaan DA di Fasilitas Primer: Studi Fenomenologi di Puskesmas Secanggang Afriyanti, Dhewi Sri; Wasliati, Balqis; Karo–karo, Tati Murni; Herlina, Herlina; Sirait, Reni Aprinawaty
PubHealth Jurnal Kesehatan Masyarakat Vol. 4 No. 3 (2026): Edisi Januari
Publisher : Ilmu Bersama Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56211/pubhealth.v4i3.1580

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Dermatitis atopik (DA) merupakan penyakit kulit kronis pada anak yang memerlukan pengelolaan jangka panjang dan keterlibatan aktif orang tua. Program pendidikan orang tua di fasilitas kesehatan primer menjadi strategi penting dalam meningkatkan kemampuan keluarga mengelola DA. Penelitian ini bertujuan untuk mengeksplorasi persepsi dan hambatan orang tua dalam mengikuti Program Pendidikan Pengelolaan DA di Puskesmas Secanggang. Penelitian menggunakan pendekatan kualitatif dengan desain fenomenologi. Data dikumpulkan melalui wawancara mendalam terhadap 10 orang tua yang memiliki anak usia 0–5 tahun dengan diagnosis DA dan dianalisis menggunakan analisis tematik. Hasil penelitian menunjukkan bahwa orang tua memiliki motivasi tinggi untuk mengikuti program, pengalaman positif selama proses edukasi, serta memaknai program sebagai, meskipun motivai tinggi dan sarana pemberdayaan dalam pengelolaan DA anak banyak hambatan berupa keterbatasan waktu kerja, jarak ke Puskesmas dan kurangnya dukungan keluarga. Program pendidikan berkontribusi terhadap peningkatan pengetahuan, perubahan perilaku perawatan, dan penurunan kecemasan orang tua.
Analysis of the Casemix Team Performance on the Quality of Health Services and Outpatient Patient Satisfaction at Grandmed Hospital in 2025 Anggi Kurnia Ningsih; Rahmadani Sitepu; Tati Murni Karo Karo
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 2 (2026): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/6mxgnr55

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The The implementation of the Casemix system through INA-CBG’s as part of the National Health Insurance (JKN) program requires hospitals to improve efficiency while maintaining service quality. The performance of the Casemix team plays a crucial role in ensuring coding accuracy, claim timeliness, and cost control. This study aimed to analyze the factors influencing the performance of the Casemix team and its relationship with service quality in the Outpatient Unit of RS Grandmed Lubuk Pakam in 2025.This research used a mixed methods approach with a sequential explanatory design. Quantitative data were collected from 93 JKN outpatient respondents selected using the Slovin formula and accidental sampling technique. Data were analyzed using univariate, bivariate (Chi-Square test), and multivariate (multiple logistic regression) analyses. Qualitative data were obtained through in-depth interviews with five key informants selected purposively and analyzed using thematic analysis.The results showed that most respondents rated human resources (62.4%), SIMRS-based Casemix system (65.6%), facilities and infrastructure (59.1%), financing (67.7%), service quality (64.5%), and Casemix team performance (63.4%) in the good category. Bivariate analysis indicated that all independent variables had a significant effect on Casemix team performance (p < 0.05). Multivariate analysis revealed that service quality was the most dominant factor influencing Casemix team performance (OR = 6.46; p = 0.000), followed by human resources (OR = 4.10; p = 0.002) and financing (OR = 3.44; p = 0.006). In conclusion, the success of Casemix implementation in the outpatient unit is influenced by a combination of human resources, information systems, financing mechanisms, and service quality. Strengthening human resource competence and improving service quality are key strategies to optimize Casemix team performance and enhance hospital service efficiency
The Effect of Implementing an Electronic Medical Record (EMR) System on Patient Data Management at the Outpatient Clinic of Rumkit Tk. IV 01.07.02 Binjai in 2025 Anna Ivra Soleliza Jones; Felix Kasim; Tati Murni Karokaro
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 2 (2026): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/1h37da70

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The Electronic Medical Record (EMR) system is a crucial component in improving the quality of healthcare services through fast, accurate, and integrated patient data recording. The Outpatient Clinic of Rumkit Tk. IV 01.07.02 Binjai has fully implemented the EMR system; however, its implementation still faces several challenges, including limited computer devices, network disruptions, unstable electricity, and variations in users’ ability to operate the system, which may affect the effectiveness of patient data management. This study aims to analyze the effect of EMR implementation on patient data management, including time efficiency, data accuracy, cost savings, and healthcare workers’ satisfaction. This research employed a quantitative approach with a descriptive-analytic design, involving a sample of 38 healthcare workers representing the total population of EMR users. Data were collected using a Likert-scale questionnaire that had been tested for validity and reliability, supported by observation. Data analysis was conducted using univariate analysis, bivariate analysis with the chi-square test, and multivariate analysis using multiple linear regression. The results showed that EMR implementation was significantly associated with time efficiency, data accuracy, cost savings, and healthcare workers’ satisfaction (p < 0.05). Regression analysis indicated that data accuracy and time efficiency were the most dominant variables contributing to improved patient data management. It can be concluded that the implementation of the EMR system has a significant effect on patient data management at the Outpatient Clinic of Rumkit Tk. IV 01.07.02 Binjai. Therefore, improvements in technological infrastructure, routine training, and handling of technical obstacles are needed to optimize EMR utilization and maximize its impact on healthcare service quality.
The Influence of Emergency Service Management Policies on Response Time and Service Quality at RSUD Bangun Purba, Deli Serdang Regency, in 2026 Ariza, Rieska; Rahmad Gurusinga; Tati Murni Karokaro
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 2 (2026): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/xgr2w111

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Emergency services represent the frontline of hospital care and require optimal response time and high-quality service delivery, with response time and service quality serving as key performance indicators. The achievement of these indicators is strongly influenced by the implementation of effective emergency service management policies. This study aimed to analyze the effect of emergency service management policies on response time and service quality at Bangun Purba Regional General Hospital, Deli Serdang Regency, in 2025. This study employed a quantitative analytical design, with the study population consisting of patients and/or patients’ families who received services at the Emergency Department of Bangun Purba Regional General Hospital. Data were collected through questionnaires and observation, and analyzed using univariate analysis to describe the distribution of study variables and bivariate analysis to examine the relationships between variables. The univariate analysis indicated that emergency service management policies were generally perceived as moderate to good, while response time performance had not fully met the minimum service standards. Bivariate analysis revealed a statistically significant relationship between emergency service management policies and response time (p < 0.05), as well as between management policies and service quality (p < 0.05). Response time was also significantly associated with service quality (p < 0.05), indicating that faster response time was associated with better perceived service quality. In conclusion, emergency service management policies play a crucial role in improving response time and service quality in the emergency department, highlighting the need for strengthened policy implementation, improved adherence to standard operating procedures, and continuous evaluation to enhance service quality and patient safety.
Analysis of Minimum Service Standards on General Patients’ Revisit Intention at the Outpatient Department of RS Grandmed Lubuk Pakam in 2026. Maharani, Putri; Ramadhani Sitepu; Tati Murni Karokaro
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 2 (2026): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/chtfx419

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This research aimed to examine the influence of Minimum Service Standards (MSS), which include human resources, facilities and infrastructure, management and governance, and budget, on the revisit intention of general outpatients at RS Grandmed Lubuk Pakam in 2026. The study applied a quantitative method using a cross-sectional design. The population consisted of all general patients who had made repeat visits, with a sample of 95 respondents selected through purposive sampling. Data were gathered using structured questionnaires and analyzed through the Chi-square test for bivariate analysis and multiple logistic regression for multivariate analysis. The results of the univariate analysis indicated that most respondents considered human resources (75.8%), facilities and infrastructure (80.0%), management and governance (60.0%), and budget (71.6%) to be in poor condition. In addition, the majority of respondents showed a low level of revisit intention (54.7%). The bivariate analysis demonstrated significant associations between human resources (p=0.006), management and governance (p=0.017), and budget (p=0.007) with revisit intention. Meanwhile, facilities and infrastructure did not show a significant relationship with revisit intention (p=0.081). The multivariate analysis revealed that human resources had a significant impact on revisit intention (p=0.041), whereas management and governance and budget variables were not statistically significant. In summary, human resources were identified as the most influential factor affecting revisit intention among general outpatients. Therefore, efforts to improve staff competence, professionalism, and service attitudes should be prioritized in order to strengthen patient loyalty and promote repeat visits.
Co-Authors Abdi Lestari Sitepu Abdi Lestari Sitepu Abdy Lestari Sitepu Ade Muliani Afriyanti, Dhewi Sri Alfrisa, Bagus Amel Yanis Amriani Eva Perawati Silalahi Anggi Kurnia Ningsih Anita Sri Gandaria Purba Anita Sri Gandaria Purba Anna Ivra Soleliza Jones Arfah May Syara Arfah May Syara Ariza, Rieska Armansyah Berampu Balqis Wasliati Br. Turnip, Nur Ulina M Bunga Br Saragih Damayanti . Dian Anggriyanti Dian Anggriyanti Diki Muliani Dray Kelvin Pandiangan Fazar Witama Felix Kasim Fredy Kalvind Tarigan Hardisman Hariati Hariati Hayati, Kardina Herlina Herlina Ida Yolanda Irma Nurianti Junita Ika Susanti Br Ginting Kardina Hayati Kardina Hayati Karnirius Harefa Latifatul Robbaniyah Lia Hasrawi Melisa Queen Hutabarat Mif Zannah Miftahul Zannah Mila Gustia Mila Gustia Muhammad Riduan N.C Sitanggang, Margaretha Nurhapni Pulungan Nurul Fernanda Williani Peni Rio Ginting Pratiwi Christa Simarmata Purba, Novandi Putra Harahap, Bahdi Mandala Putri Maharani Putri, Puji Audina Rahmad Gurusinga Rahmad Gurusinga Rahmadani Sitepu Raisha Octavariny Ramadhani Sitepu Ramdanil Arifin Rawaty Sitorus Ribka Erika Romauli Anna Teresia Marbun Romi Syahputra Tarigan Rosita Ginting Safril Matua Harahap Sari Desi Esta Ulina Sitepu Sari Desi Esta Ulina Sitepu Sari Desi Esta Ulina Sitepu Sarmana . Sarmana Sarmana Selamat Tuahta Sipayung Simarmata, Juni Mariati Sirait, Reni Aprinawaty Siti Sarah Bintang Situmorang, Novidawati Sri Julia Ningsih Sri Melda Bangun Sri Yana Syaputra Tarigan, Romi Syatria Wati Syatriawati Suhaimi Syatriawati Syatriawati Tania Diah Masitah Ucu Suherman Wasliati, Balqis Wati, Indah Widya . Winardi Silaen Zuidah