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Evaluation of Quality Indicators with Lean Six Sigma In Pre and Post Analytical Laboratories Nurhadi, Muhammad Ihsan; Ridwanna, Surya; Rinaldi, Sonny Feisal; Nurhayati, Betty
Mukhtabar Journal of Medical Laboratory Technology Vol 3 No 1 (2025): Mukhtabar: Journal of Medical Laboratory Technology (April 2024)
Publisher : LPPM STIKes Muhammadiyah Ciamis

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52221/mjmlt.v3i1.795

Abstract

Background & Objective: Medical laboratories have an important role of 60-70% in diagnosis, patient monitoring, and prevention and treatment of diseases. Therefore, the laboratory must maintain and ensure the quality of service process. This study aims to determine the sigma value and identify waste in pre and post analytical in the laboratory, as well as determine Improvement proposals in order to reduce errors pre and post analytical laboratory. Method: This research design is descriptive study that Analyzes the process and quality indicators at pre and post analytical with the Lean Six Sigma approach, which is a combination of Lean methods that focus on eliminating waste and Six Sigma that focuses on eliminating defects. This research was conducted as a process Improvement effort with five Six Sigma work steps (DMAIC) and identified eight types of waste (DOWNTIME). Result: The results showed that the sigma value at pre and post analytical was 4.6 and 3.5 Sigma, and total sigma value for pre-post analytical was 4.3 Sigma so that both had not met the minimum target achievement of 5 Sigma (Excellent). There are two quality indicators that require improvement and enhancement including suitability of sample and TAT. The results also show that there are 4 wastes, consisting of 1 Defects, 1 Waiting, and 2 Not Utilizing Employees Knowledge. Conclusion: Proposed Improvements are then given so that all waste identified in this study can be minimized so that the achievement of sigma quality indicators can increase.
KORELASI KADAR FERRITIN DAN KADAR IL-6 TERHADAP SATURASI OKSIGEN PADA PASIEN COVID-19 DI RUMAH SAKIT ADVENT BANDUNG Tania, Monica; Nurhayati, Betty; Hayati, Eem; Durachim, Adang
Journal of Medical Laboratory and Science Vol 5 No 1 (2025): JMLS: Journal of Medical Laboratory and Science
Publisher : Jurusan Teknologi Laboratorium Medis, Poltekkes Kemenkes Palembang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36086/medlabscience.v5i1.2086

Abstract

Background: Covid-19 was first discovered in late 2019 in Wuhan, China caused by the coronavirus-2 or SARS-Cov-2. This virus causes a cytokine storm characterized by hyperferritinemia and increased IL-6 levels. Most Covid-19 patients require ventilator assistance due to severe pneumonia, alveoli damage, lung parenchyma damage, and the occurrence of Acute Respiratory Distress Syndrome (ARDS) characterized by decreased oxygen saturation. Objective: to find a correlation between Ferritin levels and IL-6 levels on oxygen saturation. Methods: The type of research used is descriptive. The study population and samples were all patients of Advent Hospital Bandung who were admitted to the ICU room infected with Covid-19 with a positive PCR value with a CT value <40 and examined for Ferritin, IL-6 and oxygen saturation parameters in the period January-December 2021. And using the Spearman correlation statistical test. Results: It is known that the average Ferritin level is 1,528.04 ng/mL, the average IL-6 level is 238.35 pg/mL and the average oxygen saturation value has an average value of 90.1%, and there is a correlation between Ferritin levels and oxygen saturation of 29.7%, but there is no correlation between IL-6 levels and oxygen saturation. Conclusion: there is a correlation between Ferritin levels and oxygen saturation which has a weak level of relationship. Suggestion: Ferritin is recommended as an initial examination to indicate the good and bad condition of Covid-19 patients and can help clinicians in better and faster management of Covid-19 patients, because there is a relationship with oxygen saturation values.
CORRELATION OF NEUTROPHIL LYMPHOCYTE RATIO (NLR) VALUES WITH C-REACTIVE PROTEIN (CRP) LEVELS IN PNEUMONIA PATIENTS Maryani, Nita; Nurhayati, Betty; Dermawan, Asep; Abror, Yogi Khoirul; Thayyiba, Amina
JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, Online ISSN 2579-8103 Vol 17 No 2 (2025): Jurnal Riset Kesehatan Poltekkes Depkes Bandung
Publisher : Poltekkes Kemenkes Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34011/juriskesbdg.v17i2.2831

Abstract

Pneumonia is an acute infection of the lungs caused by microorganisms such as bacteria, viruses, or fungi, which trigger inflammation and weaken the immune system. Early detection is crucial for guiding treatment strategies and reducing the risk of complications. One indicator that can be used for the systemic inflammatory response due to pneumonia infection is the Neutrophil Lymphocyte Ratio (NLR). In addition to NLR, C-Reactive Protein (CRP) levels can also be examined to determine the level of infectious disease activity. This study aimed to assess the correlation between NLR values and CRP levels in pneumonia patients. This is a descriptive correlational study with a cross-sectional design that was conducted on 25 adult and elderly pneumonia patients with comorbidities, selected through consecutive sampling. This research was conducted at Dr. H. A. Rotinsulu Lung Hospital, with the research time being November 6 –18, 2024. The mean neutrophil percentage was 76.9%, lymphocytes 13.4%, NLR 9.12, and CRP level 83 mg/L. Spearman’s correlation test showed a significant positive correlation between NLR and CRP (r=0.415, p=0.039). These results indicate that higher NLR values are associated with increased CRP levels in pneumonia patients.
Implementasi Model Inkola (Informasi, Komunikasi, dan Tatakelola) dalam Pengelolaan Anak Penyandang Diabetes Tipe 1 pada Program Pengembangan Desa Sehat di Wilayah Bandung Raya dan Cimahi Widiawati, Ida; Rumahorbo, Hotma; Sasmita, Anah; Kusniasih, Susi; Nurhayati, Betty; Damayanti, Didit
Poltekita: Jurnal Pengabdian Masyarakat Vol. 6 No. 1 (2025)
Publisher : Pusat Penelitian & Pengabdian Masyarakat Poltekkes Kemenkes Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33860/pjpm.v6i1.4063

Abstract

There is an increasing number of cases of children with type 1 diabetes in the community, especially in the Greater Bandung area and Cimahi City, there are 50 children with diabetes who need special treatment. The InKoLa (Information, Communication and Governance) model is a sustainable care model that has been empirically proven to improve the quality of life of children with diabetes and control blood sugar. The purpose of implementing the InKoLa Model is to improve the ability and independence of parents in caring for children and improve the ability of teachers/school parties to assist children at school and provide optimal health services by Puskesmas health workers. This model was implemented using training/education and mentoring methods in partner areas with a target group of 30 children and parents, 10 teachers/school officials and 12 Puskesmas health workers. The increase in parents' knowledge in the good category by 43.3%, high self-efficacy increased by 43.5%; UKS teacher knowledge in the good category increased by 40% and high self-efficacy increased by 40%. Children's knowledge in the good category increased by 42.6% and self-efficacy increased by 60%.  The meeting resulted in a common perception and commitment to bring optimal information, communication and governance at home and school. The INKOLA model was implemented to manage children with type 1 diabetes in the community. It is recommended that the Health Office and Puskesmas use the InKoLa model to manage children with type 1 diabetes in the community.
The The Effect of Blood Transfusion Frequency on Secretor Status Titer in Saliva and Urine Specimens of Thalassemia Patients Darmantoputro, Feby Wicaksono; Nurhayati, Betty; Hayati, Eem; Marliana, Nina
Journal of Indonesian Medical Laboratory and Science Vol 6 No 2: Oktober 2025
Publisher : Asosiasi Institusi Pendidikan Tinggi Teknologi Laboratorium Medik Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53699/joimedlabs.v6i2.308

Abstract

Background: Thalassemia is a disease caused by a deficiency or loss of synthesis of one or more normal globin chains. In diseases that require blood transfusions, such as Transfusion Dependent Thalassemia (TDT), it is very important to examine the blood type to determine the blood to be transfused. The ABO blood type system antigen or secretor, is found in body fluids in the form of dissolved antigens, including in saliva and urine. Interference can be caused by the frequency of transfusion, which can change the secretor content in the saliva and urine of thalassemia patients, causing false negatives in the examination of secretor status. Objectives: This study aims to determine the effect of transfusion frequency on the titer of secretor status in saliva and urine specimens of Thalassemia patients. Materials and Methods: The type of study is quasi-experimental, Agglutination-Inhibition method. The research sample was 23 Thalassemia major patients. 15 patients are secretor patients, with a frequency of 1x transfusion a month were 7 people (47%), a frequency of 2x transfusion a month were 5 people (33%), and 4x transfusion a month were 3 people (20%). Results: The results of the study on Thalassemia patients obtained from saliva were titers between 1/8 to 1/256. From urine, the results were non-secretors. In contrast to previous studies, which stated that urinary is still detected but four times weaker than saliva. Based on the ANOVA statistical calculation, sig. 0.909 (p>0.05) was obtained. Conclusions: The conclusion is that there is no effect of transfusion frequency on the titer of secretor status in saliva or urine.
THE EFFECT OF STORAGE TIME AND TYPE OF ANTIKOAGULANT IN PLATELET RICH PLASMA (PRP) ON PLATELET COUNTS Lestari, Felia; Noviar, Ganjar; Nurhayati, Betty; Hayati, Eem
Meditory : The Journal of Medical Laboratory Vol 12, No 2 (2024): Meditory, Volume 12 No. 2 Tahun 2024
Publisher : Jurusan Teknologi Laboratorium Medis, Poltekkes Kemenkes Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33992/meditory.v12i2.3397

Abstract

Background: Platelet Rich Plasma is a biological product in the form of autologous plasma produced from the centrifugation process of blood specimens and has a platelet concentration above normal values. Things that can affect the results of PRP are blood collection, centrifugation speed, centrifugation time and temperature and the use of anticoagulants. Aims: The purpose of this study was to determine the average and see the effect of sodium citrate anticoagulant and ACD-A anticoagulant by using a shelf life of 0 hours, 4 hours and 8 hours in PRP on platelet count. Methods: This type of research is a pseudo-experiment with a Statistica Group Comparison research design. The number of samples in this study were 6 people. PRP research data on platelet count was processed statistically with the General Linear Model (GLM) method. The Results: The average data of PRP on platelet count using sodium citrate anticoagulant with a shelf life of 0 hours 533.333 cell/µL; 4 hours 527.167 cell/µL; 8 hours 190.167 cell/µL. Average data of PRP on platelet count using ACD-A anticoagulant with a shelf life of 0 hours 986.333 cell/µL; 4 hours 976.500 cell/µL; 8 hours 634.833 cell/µL. The data results for 0 hour and 4 hour shelf life on anticoagulants Sodium Citrate and ACD-A have a Sig value of 0.646 0.05 while 8 hour shelf life has a Sig value of 0.000 0.05. Conclusion: No effect of 0 hour and 4 hour shelf life while there is an effect of 8 hour shelf life and there is an effect of anticoagulants Sodium Citrate and ACD-A in PRP on platelet count.
DIAGNOSTIC TEST OF MOLECULAR RAPID TEST AGAINST REAL-TIME PCR ON DETECTING BCR-ABL CHRONIC MYELOID LEUKEMIA Pratama, Resta Ratna Juwita; Nurhayati, Betty; Merdekawati, Fusvita; Hayati, Eem; Ernawati, Ernawati
JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, Online ISSN 2579-8103 Vol 17 No 2 (2025): Jurnal Riset Kesehatan Poltekkes Depkes Bandung
Publisher : Poltekkes Kemenkes Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34011/juriskesbdg.v17i2.2865

Abstract

Chronic Myeloid Leukemia (CML) is a condition characterized by abnormal proliferation of hematopoietic cells and can occur across various age groups. Detection of Breakpoint Cluster Region-Abelson (BCR-ABL) is essential to identify the presence of the Philadelphia chromosome (Ph 1 chr). Real-Time Polymerase Chain Reaction (Real-Time PCR) is the gold standard for BCR-ABL detection, but it has limitations such as long processing time and high cost. The Molecular Rapid Test (TCM) using the GenXpert platform offers a faster and more practical alternative. This study aimed to evaluate the performance of TCM BCR-ABL compared to Real-Time PCR. A cross-sectional design was applied with 54 samples obtained using consecutive sampling based on Lemeshow’s formula. The results showed a sensitivity of 91%, specificity of 90%, positive predictive value (PPV) of 94%, and negative predictive value (NPV) of 86%. Wilcoxon test analysis revealed no significant difference between the two methods (p=0.100). In conclusion, TCM demonstrates diagnostic performance comparable to Real-Time PCR and has the potential to be used as a rapid and efficient alternative for CML detection.