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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 Risk Factors Influencing the Incidence of Diabetes Mellitus among Employees Rachmawati, Ira Puspa; 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.v7i5.6697

Abstract

Diabetes Mellitus (DM) is a chronic metabolic disorder that remains a major public health concern globally. Its prevalence is influenced by various lifestyle and hereditary factors. This study aims to analyze the risk factors contributing to the incidence of DM among employees at Segiri Community Health Center. A retrospective case-control study was conducted using secondary data from health screenings and fitness assessments of Segiri Community Health Center employees in September 2023. From 50 staff members, 40 with complete records were included: 10 DM cases and 30 non-DM controls (1:3 ratio). Data included medical history, lifestyle behaviors, and anthropometric measurements. Analysis involved univariate and bivariate tests using cross-tabulation and Odds Ratio (OR). The most significant risk factor was abnormal Body Mass Index (BMI), as all DM cases had abnormal BMI values. Other influential factors included parental history of diabetes (OR = 18.0), personal history of hypertension (OR = 9.3), and parental history of hypertension (OR = 6.0). Additional contributing factors were low fruit and vegetable intake (OR = 4.0), excessive salt intake (OR = 1.63), and abnormal waist circumference (OR = 1.31). Smoking and alcohol consumption were not significantly associated with DM in this sample. Abnormal BMI and a family history of diabetes and hypertension significantly contribute to the incidence of DM. Targeted interventions focusing on these modifiable and non-modifiable risk factors are essential for effective workplace prevention strategies.
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 Risk Factors for Chronic Kidney Failure Sudarmiyati, Nunuk; Pakki, Irfansyah Baharuddin; Ramdan, Iwan Muhamad
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.v7i5.6649

Abstract

The background of this study focused on the increasing incidence of chronic renal failure at Kudungga Sangatta Hospital, East Kutai Regency, which is a serious concern in an effort to improve the quality of public health services. The general objective was to analyze the risk factors of chronic renal failure in Kudungga Sangatta Hospital, East Kutai Regency. This type of research is an analytic observational research with case control design or case control study. The non-random sampling method is purposive sampling as many as 140 people, as for data collection techniques, namely, the preparation stage (preparing a research permit, and conducting a preliminary study), after that there is an implementation stage (collecting respondent data, sorting samples according to sample criteria in two sample groups, filling out questionnaire data, and collecting research instruments). The data analysis techniques in the study were editing, coding, shorting, data entry, and data cleaning. Age was significantly associated with the incidence of acute renal failure (P < 0.001). Family history of hypertension is significantly associated with the incidence of acute renal failure (P < 0.001, OR = 69.750). Family history of diabetes mellitus was not significantly associated with the incidence of acute renal failure (P = 0.806). Taking Analgesic and NSAID drugs were not significantly associated with the incidence of acute renal failure (P > 0.05). The conclusion is that there is a relationship between age and family history of hypertension with the incidence of chronic renal failure and there is no relationship between family history of diabetes mellitus, and using analgesic drugs and NSAIDs is not significantly related to the incidence of acute renal failure at Kudungga Sangatta Hospital, East Kutai Regency.
Analysis of Factors Associated with the Incidence of Dengue Hemorrhagic Fever (DBD) Astuti, Astuti; Pakki, Irfansyah Baharuddin; Ramdan, Iwan Muhamad
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.v7i5.6650

Abstract

Dengue fever is still a public health problem worldwide, especially in tropical and subtropical regions. Data from around the world shows that Asia ranks first in the number of Dengue Fever sufferers each year. The purpose of this study was to determine the factors that affect the incidence of Dengue Fever (DHF) in the work area of BLUD Puskesmas Sangatta Utara, Kecamatan Sangatta Utara, Kabupaten Kutai Timur. This study used a case-control design, with 115 positive cases of DHF and 115 control cases in the work area of BLUD Puskesmas Sangatta Utara, East Kutai Regency, making a total of 230 samples. The data collection techniques included a preparation stage (obtaining research permits and conducting a preliminary study), followed by an implementation stage (collecting respondent data, sorting samples according to criteria into two groups, filling out questionnaires, and collecting research instruments). This study found a significant association with the incidence of DHF in the following variables: knowledge (p < 0.001) OR 0.061, daytime activity (p < 0.001) OR 2.878, mosquito nest eradication efforts (p < 0.001) OR 0.118, and the habit of hanging used clothes in the house (p < 0.001) OR 8.576. It can be concluded that the habit of hanging used clothes in the house is the most dominant variable associated with the incidence of DHF in the work area of BLUD Puskesmas Sangatta Utara (Odds Ratio Exp(β) = 89.297).
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.
Gambaran Kasus Gondongan pada Siswa SD Normal Islam Samarinda Wardani, Nunuk Kusuma; Saputri, Deby Indah; Nugraha, Purwa; Nozomi, Alwan Zakki; Noor, Muhammad; Wisnuwardani, Ratih Wirapuspita; Pakki, Irfansyah Baharuddin
Jurnal Epidemiologi Kesehatan Komunitas Vol 10, No 3: Agustus 2025
Publisher : Master of Epidemiology, Faculty of Public Health, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jekk.v10i3.25482

Abstract

Background: Mumps is a contagious disease caused by paramyxovirus infection that primarily affects children and adolescents. In 2024, a surge of mumps cases was reported in Samarinda, particularly at Sekolah Dasar Normal Islam Samarinda. This study aimed to describe the characteristics of mumps cases based on age, sex, and epidemiological distribution at the school during October–November 2024.Methods: This descriptive observational study utilized primary and secondary data. Purposive sampling was applied to include students who met the clinical diagnostic criteria for mumps, identified through school health reports and direct observation. Data collection covered number of cases, age, sex, symptoms, and transmission patterns. Analysis was performed descriptively using Microsoft Excel. A total of 78 students were identified with mumps symptoms. The index case was reported on October 3, 2024, in a male fifth-grade student presenting parotid gland swelling, fever, and history of close contact within the past 25 days.Results: The majority of cases occurred among male students (61.5%), particularly those in grades 5 and 6, with 11 years old being the most affected group. The most common clinical manifestations included fever and parotid gland swelling. Notably, none of the students had received the MMR vaccination. The epidemic curve showed a sharp increase in October 2024, followed by a decline in November, with an overall attack rate of 12.5%.Conclusion: Low immunization coverage, overcrowded classrooms, and delays in early detection played a significant role in facilitating transmission within the school. Strengthening vaccination programs, implementing health education, improving hygiene protocols, and ensuring early isolation of suspected cases are recommended to control and prevent further mumps outbreaks in school settings. Keywords: Mumps; epidemiology; imunization; disease prevention; school children