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Analysis of Factors Related to the Incidence of Ventilator-Associated Pneumonia (VAP) in the Intensive Care Unit Cahyana, Yudi Jaya; Pakki, Irfansyah Baharuddin; Lestari, Ida Ayu Indira Dwika; Adrianto, Ratno; Yadi, Yadi; Azmiardi, Akhmad
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6628

Abstract

Ventilator-associated pneumonia (VAP) occurs in patients who have been on mechanical ventilation with an endotracheal tube (ETT) for at least 48 hours. This type of pneumonia typically arises as a result of nosocomial infections or Healthcare-Associated Infections (HAIs) and is commonly linked to the use of ventilators in hospital settings. This study was to identify the factors associated with the incidence of VAP among patients admitted to the Intensive Care Unit of Abdoel Wahab Sjahranie Hospital, Samarinda. Method: A cross-sectional study was conducted. The study population consisted of all patients who had undergone mechanical ventilation in the ICU without a prior history of pneumonia, totaling 118 respondents, using the HAIs bundle observation tool and direct observation. Chi-square and multiple logistic regression were used for statistical analysis, along with a predictive model. The results showed that the prevalence of VAP among respondents in the ICU was 5.9%. Factors significantly associated with the incidence of VAP included duration of ventilator use (p = 0.000), oral hygiene procedures (p = 0.000), head-of-bed elevation to 30–45° (p = 0.007), hand hygiene compliance (p = 0.015), and aseptic suctioning procedures (p = 0.043). The multivariate analysis identified duration of ventilator use ≥96 hours as the most dominant factor, with the highest Odds Ratio (OR = 13.975; 95% CI: 0.753–227.435). Duration of ventilator use was the most significant factor associated with an increased risk of VAP, with patients ventilated for ≥96 hours being 13 times more likely to develop VAP compared to those ventilated for <96 hours. Proper oral hygiene, appropriate head-of-bed elevation (30–45°), compliance with hand hygiene, and aseptic suctioning procedures were also found to be significantly associated with VAP incidence among ICU patients at Abdoel Wahab Sjahranie Hospital
Analysis of the Relationship Between the Implementation of the Clinical Pathway for NSTEMI Disease and Service Variance Hapsari, Palupi Setyo; Adrianto, Ratno; Pakki, Irfansyah Baharuddin
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6773

Abstract

This research was conducted to address the increasing number of NSTEMI (Non-ST Elevation Myocardial Infarction) cases, which represent a significant portion of heart attack patients (85%) according to the 2023 Ischemic Myocardial Infarction National Audit. The challenge for healthcare providers is to ensure optimal care for these patients. Clinical Pathways are structured guidelines designed to improve service quality, but despite a relatively high compliance rate (82%) for filling out Clinical Pathways at Taman Husada Bontang Hospital, there has been no clear analysis of how Clinical Pathway implementation benefits patient outcomes. Therefore, the study aims to evaluate the relationship between the implementation of Clinical Pathway and the quality of care provided to NSTEMI patients. The study aims to analyze the relationship between the implementation of the Clinical Pathway for NSTEMI patients and the quality of service at Taman Husada Bontang Hospital. Quantitative research method with a cross-sectional case study approach. The sample technique used is non-probability sampling; the number of samples is 50 Clinical Pathway forms from NSTEMI patients treated at the hospital during the 2022-2023 period. The Chi Square test on the service variance variable has a significant relationship with the implementation of Clinical Pathway, with a p value of 0.000 < 0.05, incomplete documentation resulting in a lack of information about the service variance provided with an OR value of 1.5. The conclusion is that the implementation of Clinical Pathway is significantly related to the quality of services, especially the variance of actions given to patients. To improve service quality, improvements are needed in documentation and regular evaluation of the implementation of the Clinical Pathway.
Analysis of Activity Based Costing (ABC) Calculations in Services Hemodialysis at the Kudungga Regional Hospital Dialysis Unit Wijayanti, Dwi Astuti Noor; Adrianto, Ratno; Ramdam, Iwan Muhammad; Pakki, Irfansyah Baharuddin; Kamaruddin, Iriyani; Bahtiar, Rahmat
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6871

Abstract

Hemodialysis is a kidney replacement therapy where blood from outside the body is filtered by a machine. The provision of hemodialysis services currently still uses the old rates and is considered not to provide profits for hospitals, so good calculations are needed as a form of efficiency in financing hemodialysis procedures in hospitals, especially in the JKN era. Hospitals will receive comprehensive information on shopping costs, unit cost calculations and action suggestions in accordance with applicable rates. The study was carried out with the aim of finding out the unit cost rates for hemodialysis services in the Kudungga Regional Hospital Dialysis Unit using the Activity Based Costing (ABC) method and comparing them with INA-CBGs rates and hospital rates. This research uses a descriptive and quantitative approach. Unit costs for dialysis units and cost analysis using the Activity Based Costing (ABC) method approach are the main subjects of this research. This research is based on all financial balance data for hemodialysis services at the Kudungga Regional Hospital Dialysis Unit. The unit cost of hemodialysis can be determined by tracing the costs related to the hemodialysis cost center as a production center and other elements that support this action. The data will be grouped into fixed costs, semi-variable costs and variable costs, then included in direct costs, indirect costs, overhead and unit cost calculations using the Activity Based Costing (ABC) method. The research results show that the unit cost calculation for hemodialysis based on the Activity Based Costing (ABC) method is IDR 1,397,627.79. Meanwhile, the Kudungga Regional Hospital rate is only IDR 1,258,300, the hospital rate only meets 90.03% of the unit cost using the ABC method. Meanwhile, when compared with the INA-CBGs tariff, which is IDR 921,300, the INA-CBGs tariff only meets 65.92% of the unit cost using the ABC method. Things that influence are direct costs, indirect costs and the number of hemodialysis procedures.
Calculation Rational Rates Based on Unit Costs Compared to Kudungga Hospital Surgical Instalation Rates Setianingtyas, Endah Dwi; Adrianto, Ratno; Ramdan, Iwan Muhamad; Pakki, Irfansyah Baharuddin; Kamaruddin, Iriyani; Bahtiar, Rahmat
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6872

Abstract

Hospitals that have carried out unit cost calculations can find out how much they are spending, so that the hospital can know if waste occurs. This is because the costs incurred by one hospital will be different from those incurred by another hospital, even though the hospital is in the same type of hospital. Apart from that, the results of unit cost calculations can also be used as a basis for decision making to improve hospital quality and quality. The aim of this research is to calculate rational rates for types of surgery using the multiple distribution method, then compare them with hospital rates for general surgery rates at the Central Surgical Installation of Kudungga Sangatta Regional Hospital. This study is a comparative descriptive quantitative analytical study to compare the rational rates of types of operations (special, special, major, major, and medium cito operations) in the general surgery group during the period of 2023 with the rates of general surgery operations at the Central Surgery Installation of Kudungga Sangatta Regional Hospital with a sample population of all 340 patients using BPJS insurance who received general surgery operations. The results of the research show that the rational rates obtained for special CITO operations are IDR 14,094,633, special operations IDR 12,383,431, large CITO operations IDR 5,262,904, large operations IDR 6,775,203, and medium operations IDR 3,858,857. Rational rates are higher than hospital rates, except for major CITO surgery rates. Therefore, when determining hospital rates, it is necessary to consider unit cost analysis so that hospital operational costs can be efficiently spent.
Analysis of Factors Affecting Job Satisfaction and Performance of Specialist Doctors Basri, Samsinar; Adrianto, Ratno; Pakki, Irfansyah Baharuddin
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6935

Abstract

There are many patient complaints regarding the performance of specialists at Kudungga Hospital. This is shown in accordance with the results of patient satisfaction surveys conducted in 2020 and 2021. From the satisfaction survey, it was concluded that the patient's complaint was the behavior of doctors who often arrived late so that the polyclinic schedule was not on time. The purpose of this study is to analyze factors related to job satisfaction and performance of specialist doctors at Kudungga Regional Hospital, East Kutai Regency.The type of research used is observational with a cross sectional design, namely a study that explores information about the phenomenon of work dissatisfaction of Specialist Doctors at Kudungga Sangatta Hospital and then analyzes the dynamics of the correlation between phenomena, between the independent variable and the dependent variable can be how far the influence between the independent variable on the dependent variable. The population and sample in this study were 30 specialist doctors who actively worked at the Kudungga Sangatta Regional General Hospital. Data collection was carried out by distributing questionnaires and collecting secondary data in the form of OPPE specialist doctors and And data analysis was carried out using univariate and bivariate analysis using the Spearman Rank test. There is a relationship between work environment conditions and promotion opportunities with job satisfaction of Specialist Doctors. Based on the results of data analysis and discussion, it can be concluded that factors related to specialist doctor job satisfaction consist of work environment conditions and promotion opportunities. The variable most closely related to specialist doctor job satisfaction is work environment conditions, which has an R value of 0.689 (a strong correlation).
Analysis of Factors Affecting Antiretroviral Adherence in HIV/AIDS Patients Makin, Mochamad; Pakki, Irfansyah Baharuddin; Azmiardi, Akhmad; Adrianto, Ratno; Yadi, Yadi; Lestari, Ida Ayu Indira Dwika
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6944

Abstract

Human Immunodeficiency Virus (HIV) remains a major global public health issue, with antiretroviral (ARV) therapy playing a critical role in its management. Adherence to ARV therapy is essential to suppress viral load, prevent drug resistance, and improve the quality of life of people living with HIV/AIDS (PLWHA). However, cases of non-adherence persist. At RSUD A. Wahab Sjahranie, a referral hospital in East Kalimantan, 16% of patients have been found to be non-adherent to their ARV medication. Ensuring adherence is vital to avoid complications and prevent HIV transmission. This study aims to identify and analyze the factors influencing ARV adherence among HIV/AIDS patients at the Anyelir Outpatient Clinic, RSUD A.W. Sjahranie, Samarinda. This study employed a quantitative analytical approach with a cross-sectional design. It involved 106 HIV/AIDS patients who were actively receiving antiretroviral therapy (ART). The independent variables included knowledge, self-efficacy, duration of therapy, side effects, family support, social support, and healthcare staff attitude. Data were collected using a structured questionnaire administered directly to respondents and supported by secondary data from medical records. A total sampling technique was applied, and data were analyzed using chi-square tests and logistic regression at a 95% significance level. A total of 85.8% of respondents were classified as adherent to ARV treatment. Bivariate analysis showed that knowledge (p = 0.019), family support (p = 0.018), social support (p = 0.011), healthcare staff attitude (p = 0.006), and self-efficacy (p = 0.002) were significantly associated with ARV adherence. Multivariate analysis identified family support (OR = 4.275), healthcare staff attitude (OR = 6.834), and self-efficacy (OR = 20.241) as the most influential factors. Knowledge, side effects, family support, social support, healthcare staff attitude, and self-efficacy are significant determinants of ARV adherence among PLWHA. Among these, self-efficacy emerged as the most dominant factor.
Analisis Faktor-Faktor yang Berhubungan dengan Kepuasan Pasien Rawat Jalan RSUD Kudungga Marinda, Indri; Adrianto, Ratno
Jurnal Kesehatan Komunitas Vol 11 No 2 (2025): Jurnal Kesehatan Komunitas
Publisher : LPPM Hang Tuah Pekanbaru

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25311/keskom.Vol11.Iss2.2158

Abstract

Medical services are assessed through indicators that gauge patient satisfaction with the services rendered by hospitals, contingent upon the quality of those services. Numerous complaints from the public regarding Kudungga Hospital persist. This study seeks to analyze the factors influencing outpatient treatment satisfaction at Kudungga Hospital. A cross-sectional approach is employed in the study, utilizing a quantitative methodology. Independent variables include access, admission process, waiting time, physical environment, doctor consultation, information for patients and the dependent variable is outpatient satisfaction. The population is outpatients at Kudungga Hospital in December 2023 as many as 3373 people. The sample technique was purposive sampling technique and through Slovin calculation there were 358 respondents as samples in this study. The research analysis used Spearman Rank and multiple logistic regression. The results showed that the factors associated with employee performance at Puskesmas were access (0.0001), admission process (0.0001), waiting time (0.0001), physical environment (0.015), doctor consultation (0.0001), information for patients (0.0001). The dominant variable was the admission process with 5.24 (95% CI OR = 2.585-10.656). The conclusion is that patient satisfaction will be high if the services provided are good starting from reception officers, hospital facilities, health workers and access to health care facilities. It is recommended that hospital management evaluate the quality of hospital services through suggestions and criticisms from patients who seek treatment.
Analisis Faktor-Faktor yang Berhubungan dengan Kinerja Pegawai Dinas Kesehatan Kabupaten Kutai Timur Tahun 2024 Astuti, Prima Yulia; Adrianto, Ratno; Nurrachmawati, Annisa
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i8.61572

Abstract

Performance appraisal is a system that is carried out periodically to review and assess individual performance. The Health Department's work results are not yet optimal, as shown by the 12 Minimum Service Standards (SPM) indicators, all SPM indicators have not reached 100% and there are four indicators that have decreased. Discipline is still low, there are often vacancies during effective office hours. The level of employee attendance at morning roll call activities held on Mondays and Thursdays is very low. This research aims to determine the relationship between work discipline, work ability, work motivation, leadership style, work environment and job satisfaction with the performance of East Kutai District Health Office employees. This was a quantitative research with cross sectional design. The population were Health Department employees with civil servant status (95 people), taken using purposive sampling method. Data analysis used logistic regression tests. The research results show that there is a relationship between work discipline (p=0.021), work ability (p=0.000), work motivation (p=0.012), leadership style (p=0.009), work environment (p=0.019) and job satisfaction (p=0.001) with the performance of East Kutai Health Department employees in 2024. The variables work ability, job satisfaction and leadership style are the variables that have the most dominant relationship with the performance of East Kutai Health Department employees in 2024. The East Kutai Health Office needs to improve employee work ability, apply a democratic leadership style, increase employee discipline, implement the best work environment and pay attention to aspects of employee satisfaction by giving awards to employees who excel.
Hubungan Mutu Pelayanan Kebidanan Dengan Kepuasan Ibu Hamil dalam Mendapatkan Pelayanan Antenatal Care di Puskesmas Muara Ancalong Kabupaten Kutai Timur Nurlinda, Fitria; Adrianto, Ratno; W, Ratih Wirapuspita.
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i8.61573

Abstract

The quality of health services is the level of individual and community health services that can improve optimal health outcomes. The maternal mortality rate in Indonesia is still a big problem, so maternal health services are a top priority in health development. The purpose of this study is to determine the relationship between the quality of midwifery services and the satisfaction of pregnant women receiving antenatal care services. This type of cross-sectional quantitative research was conducted on 95 pregnant women respondents in the Muara Ancalong Health Center area in 2024. Bivariate analysis uses chi-square test, while multivariate analysis uses logistic regression test. The results showed that there was a relationship between the security variable and the satisfaction of pregnant women (p=0.032), there was a relationship between the comfort variable and the satisfaction of pregnant women (p=0.0001), there was a variable relationship of technical competence to the satisfaction of pregnant women (p=0.0001), there was a variable relationship of access/easy access to the satisfaction of pregnant women (p=0.041) and there was a variable relationship of reliability to the satisfaction of pregnant women (p=0.002). The variables that have the greatest relationship with the satisfaction of pregnant women getting antenatal care services are comfort and technical competence. The variables of comfort and technical competence have a strong relationship with the satisfaction of pregnant women in getting antenatal care services, the suggestion of the Puskesmas to give priority to pregnant women regarding their comfort and evaluate needs related to the comfort factor of service recipients and the need to improve the competence of service providers.
A Healthy Family Home without Cigarette Smoke Adrianto, Ratno; AR, Chaerunnisa; Lenik Gah, Regina; Nurlela, Siti; Maulana, Ady; 'Aina 'Uruba, Huurul; Lasari, Aramika; Pasha, Yuliana; Khalisha, Nailah
Mulawarman International Conference on Tropical Public Health Vol. 1 No. 1 (2025): The 3rd MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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

Abstract

Objective : The goal of this program is toincrease public knowledge and awareness about the dangers of smoking to one's own health and the health of the family, thereby preventing the occurrence of chronic diseases. Research Methods/ Implementation Methods : This program uses an extension method in the form of delivering material using PowerPoint, with the reading of pre-test questions (before the material) and post-test questions (after the material) to the community in Argomulyo Village. Results : The results of the PreTest and PostTest show an increase in knowledge after the counseling. Conclusion/Lesson Learned : This program can enhance the knowledge and awareness of both active and passive smokers regarding the impacts of smoking and the dangers of smoking indoors, so that smokers can make better decisions to quit smoking and create a healthier environment for themselves and those around them. Thus, this program contributes to efforts to maintain public health and reduce the risk of diseases caused by exposure to cigarette smoke.
Co-Authors 'Aina 'Uruba, Huurul Adiyatsa, Reza Jales Mahesa Agustina, Elvi Akhmad Azmiardi Alvie Magda Lesiwal Aminah Aminah Angelina, Grace Anggraeny, Ike Anggraeni G Annisa Nurrachmawati Annisa Nurracmawati AR, Chaerunnisa AR., Chaerunnisa Astuti, Ashri Budi Astuti, Ayu Sri Mega Astuti, Prima Yulia Atthoba, La Debi Auralia, Syalmita Auralia, Syalmitha Baharuddin Pakki, Irfansyah Baharudin, Irfansyah Bahtiar, Rahmat Bakhtiar, Rahmat Basri, Samsinar Blego Sedionoto, Blego Budi, Eko Prasetya Cahyana, Yudi Jaya Chaerunnisa AR Chaerunnisa, Chaerunnisa Dahlia Dahlia Danu Putra, Muhammad Rangga Dedi Priansyah Dias Pratama Eka Dewi Sitepu, Abira Ivanca Eka Putri Rahayu Elvira, Vivi Filia Fajri, Audya Nada Fatimatuzzahra, Siti Firnanda, Rivana G, Ike Anggraini Gloria Priska Britani Sumlang Hamri, Ahmad Ahsyar Hapsari, Palupi Setyo Hasibuan, Juliana Hilda Hilda Hutauruk, Hutauruk Huwaidah, Ayu Ike Anggraeni Imanuddin, Khairul Irfansyah Baharuddin Pakki Iriyani K Iriyani Kamaruddin, Iriyani Isnaniah, Enny Ivanca, Abira Iwan M. Ramdan Iwan Muhamad Ramdan Jami'an, Jami'an Jumliana, Jumliana K., Iriyani Kartikasari , Dina Khalisha, Nailah Khalishah az Zahra Kurniawan Khotimah, Vika Khusnul Khusnul, Vika Kurniawan, Khalishah az Zahra Lasari, Aramika Laura, Najoan Brigitta Lenik Gah, Regina Lestari, Ayu Indira Dwika Lestari, Ida Ayu Indira Dwika Listiyani, Dwi Mahardhika, Rizqa Mardiana, Desy Indah Marinda, Indri Masruroh1,2, Ah Yusuf3 , Nikmatur Rohmah4, Irfansyah Baharudin Pakki5 , Anita Dewi Prahastuti Prasojo6 , Qurnia Andayani1 , *Agung Dwi Laksono7 Maulana, Ady Mochamad Makin, Mochamad Mualimin, Jaya Muhammad Rangga Muhammad Sultan Muhammad Sultan, Muhammad Nada, Abira Ivanca Audya Nada, Audya Najla, Syarifah Amira Najoan Brigitta Laura Nauli, Ruth Sekar Noor, Zulhijrian Noors, Ilfa Pratiwi M Noriah, Noriah Norsehan, Norsehan Nur Asiyah Nur Rohmah Nur, Syalmitha Auralia Nurlinda, Fitria Nursakti Nursakti Nuryanto, Muhammad Khairul Pakki, Irfansyah Bahruddin Pamowa, Agustina Simanangi Paramita, Tri Ratna Pasha, Yuliana Payung, Boli Matius Tandi Pratama, Dias Pratiwi, Fierda Eka Purnama, Tasha Citra Rahayu, Eka Putri Rahmi Susanti Ramadhani, Dewi Endah Ramdam, Iwan Muhammad Ramdan , Iwan M. Rangga, M. Ratih Wirapuspita Wisnuwardani Reny Noviasty Risky Amelia Rhamadani Riyan Ningsih Sadaria, Sadaria Saputra, Rudi Septiana, Lisa Septimaulida, Firda Setianingtyas, Endah Dwi Setiawati, Ronny Setyo Nugroho Sinar, Sinar siti nurlela Subirman - Suhargiati, Atik SUMARNI Sumarni Sumarni Syauqi, Ferdhitya Rizky Syawalia, Zheditya Ayu Taqie, Sayyid Muhammad Tistania, Nurul Rizkiana Tricindra, Dzulhannisa Ulfah, Meilida Ulpah, Rini Wahidatul Utari, Ari W, Ratih Wirapuspita. Wahyudi, Ayu Huwaidah Wahyudianto, Yogik Wardani, Citra Rizki Wijayanti, Dwi Astuti Noor Wirapuspita W, Ratih Wirapuspita Wisnuwardani, Ratih Yadi, Yadi Yunus, Mudassir