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Obstacles to the Implementation of clinical practice guidelines at Mandau District General Hospital. Sindy Zelvia; Sri Wahyuni Nasution; Ermi Girsang; Sri Lestari Ramadhani Nasution
Folia Medica Indonesiana Vol. 60 No. 2 (2024): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i2.42556

Abstract

Highlights:1. Given the suboptimal implementation of clinical practice guidelines at Mandau District General Hospital, it is important to conduct research on potential obstacles to this problem.2. The findings of this study can encourage hospitals to develop and apply effective clinical practice guidelines while also addressing the obstacles to their implementation.   Abstract Clinical practice guidelines are procedures followed by physicians to optimize healthcare services and achieve more effective outcomes. Conducted in October 2022, this study aimed to analyze the factors that hinder the implementation of clinical practice guidelines among physicians at Mandau District General Hospital, Bengkalis, Indonesia. This study used an analytical survey design and a cross-sectional approach. This study included all 85 individuals who were employed as general practitioners at the Mandau District General Hospital. The data were subjected to univariate, bivariate, and multivariate analyses. The independent t-test was used in the data analysis, with a value of p<0.05 considered significant. The results showed that there was an association between the implementation of clinical practice guidelines and several variables, including the levels of ability in recognizing and explaining clinical pictures of diseases (p=0.008), diagnosing diseases (p=0.004), carrying out initial management (p=0.000), and carrying out independent and directed management (p=0.001). Upon conducting the follow-up analysis on logistic regression, it was found that the variables that were associated with the implementation of clinical practice guidelines were the ability to carry out initial management (p=0.000, OR=65.512, 95% CI=22.048–98.835). In conclusion, physicians' insufficient ability to perform initial management hinders the implementation of clinical practice guidelines. This study suggests incorporating the findings as input in the evaluation and development of training for physicians on the implementation of clinical practice guidelines.
An Analysis Of Determinants Stunting Incidents In Toddlers At Mazo Puskesmas UPT, South Nias District Waoziduhu Ndruru; Ermi Girsang; Sri Lestari Ramadhani Nasution; Liani Br Ginting
Jurnal Scientia Vol. 13 No. 03 (2024): Education and Sosial science, June - August 2024
Publisher : Sean Institute

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Abstract

The problem of stunting is a disturbance in the growth of a child's height or body length, where the height growth does not match with increasing age, which is also an abnormal condition of the body caused by more than one factor (multifactor). So this re-search discusses many things, including analyzing the influence of clean water access, latrine access, hand washing behavior with soap (CTPS), history of exclusive breastfeed-ing and MP-ASI on the growth and development of toddlers aged 24-59 months. This research used a cross sectional study design. The research was conducted in March-April 2020. Respondents were 118 children under five (aged 24-59 months) who lived in Og-an Ilir. The selection of respondents was taken using a simple random sampling tech-nique. Stunting, a condition characterized by impaired growth and development in chil-dren due to poor nutrition, recurrent infections, and inadequate psychosocial stimulation, is a significant public health problem. Statistical analysis was carried out to identify cor-relations and potential causal relationships between these variables and the incidence of stunting. The results show that low socio-economic status and maternal education are significantly related to high stunting rates. Inadequate food intake and poor sanitation practices are also important factors. Frequent infections, especially gastrointestinal dis-eases, are known to worsen the risk of stunting in toddlers.The study concludes that a multifaceted approach is needed to address stunting, involving improved economic con-ditions, educational initiatives for mothers, improved nutrition programs, better access to health services, and improved sanitation facilities. These findings highlight the im-portance of integrated public health strategies to reduce stunting and improve the wel-fare of children in South Nias District. Further research is recommended to explore long-term interventions and their effectiveness in various settings.
An Evaluation Of The Effectiveness Of Using The Self-Registration Station (ADM) Method At The Community Health Center, Batugana District North Padang Lawas S. Shelly Hazlina Hararap; Ermi Girsang; Sri Lestari Ramadhani Nasution; Liani Br Ginting
Jurnal Scientia Vol. 13 No. 04 (2024): Education and Sosial science, September-December 2024
Publisher : Sean Institute

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Abstract

Queues arise due to the need for services exceeding the capacity of services or service facilities so that users of facilities cannot immediately get services due to busy services. Very long queues and taking too long to get a turn for service are very dissatisfying for patients with the Self-Registration Kiosk (ADM) method at Batugana Health Center aims to maximize the outpatient registration process in order to create easy, fast and comfortable services for patients. However, in its implementation there are still many elderly people who do not understand its use and sometimes there are problems with the system, thus slowing down the service process at Batugana Health Center. The purpose of this study was to evaluate the effectiveness of the use of the Self-Registration Kiosk Method (ADM) at Batugana Health Center. The method in this study is qualitative analytic. The sample in this study consisted of 4 informants including: Head of the Health Center, Head of the Self-Registration Kiosk Division, Self-Registration Kiosk Officers and Outpatients. Data were obtained through in-depth interviews with informants, then the data was analyzed by data reduction through Data Triangulation and sources, then displayed in narrative form. The results of the study showed that there was an influence of human resources, SOPs and facilities and infrastructure on the use of the Self-Registration Kiosk (ADM) method at Batugana Health Center on the evaluation of the effectiveness of the use of the Self-Registration Kiosk (ADM) Method at Batugana Health Center., has not fully implemented the use of APM effectively because the expected results have not been in accordance, namely creating fast service. At Batugana Health Center, the efforts that will be made are to re-evaluate the performance of officers on APM, determine officers who really understand the APM machine. And what will be done is to create an SOP on the use of the APM machine, check the function of the APM machine, add internet quality and add electric generators.
Vitamin C Administration Method On Osteoblast Healing In Rats Femur Bone Sri Lestari Ramadhani Nasution; Muhammad Ari Pratama; Muhammad Faridz Syahrian
INFOKUM Vol. 13 No. 02 (2025): Infokum
Publisher : Sean Institute

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Abstract

Bone, as an important organ in the body, has a fundamental role in supporting biomechanical functions, carrying out the hematopoiesis process, and maintaining calcium homeostasis. The cellular components of bone involve various types of cells, including osteogenic precursor cells, osteoblasts, osteoclasts, osteocytes, and hematopoietic elements from the bone marrow. Vitamin C, or ascorbic acid, is a water-soluble vitamin that plays an important role in the formation of collagen, skin, tendons, ligaments, blood vessels, as well as in wound healing and maintenance of cartilage, bones, and teeth. This study aims to analysed mean value and difference in the number of osteoblast cells in the femur of rats exposed to alcohol between groups receiving vitamin C. Based on the results of the One Way ANOVA test, the p value = 0.018 <0.05 was obtained, which indicated a significant difference in the average osteoblasts between groups. Furthermore, in the Post Hoc test, a difference in the mean osteoblasts was found between groups T3 and T5 with a p value = 0.029 < 0.05 and between groups T4 and T5 with a p value = 0.044 < 0.05. Conclusion: Administration of vitamin C can affect the increase in the number of osteoblast cells in the bone healing process in mice exposed to alcohol.
THE USE OF BPJS DIGITALIZATION PROGRAMS TO IMPROVE SERVICE QUALITY IN FACING THE INDUSTRIAL REVOLUTION 4.0 ERA Clinton Antony; Ermi Girsang; Sri Lestari Ramadhani Nasution
International Journal of Cultural and Social Science Vol. 6 No. 1 (2025): International Journal of Cultural and Social Science
Publisher : Pena Cendekia Insani

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53806/ijcss.v6i1.997

Abstract

The Industrial Revolution 4.0 era demands digital transformation in various sectors, including the health sector. One form of innovation in health services is the digitalization of the BPJS Kesehatan program, which aims to improve the efficiency and quality of services in health facilities. This study aims to assess the effectiveness of the use of BPJS program digitalization to improve the quality of services in facing the industrial revolution 4.0 era at Royal Prima Medan Hospital, as well as to identify obstacles faced in its implementation. The research method used is a qualitative study, where data was obtained through interviews with the hospital director, the head of the BPJS primary benefit guarantee division, and six patients using BPJS services. The results of this paper indicate that the use of BPJS digitalization at Royal Prima Medan Hospital has been running in accordance with the Standard Operating Procedure (SOP) and has had a positive impact on the acceleration of the administrative process, queue efficiency, and patient data integration. However, there are still several obstacles, such as technical disruptions in the system, limited patient understanding of technology, and instability of the internet network, which can affect the effectiveness of services. To overcome these obstacles, the hospital has made various efforts, such as providing a help desk, improving digital infrastructure, and education for patients and medical personnel. Overall, the digitalization of the BPJS Kesehatan program at RSU Royal Prima Medan has proven effective in improving the quality of service, although further system optimization and innovation are still needed so that the implementation of this digitalization can run optimally in accordance with the demands of the Industrial Revolution 4.0.
The Influence Of Role, Supervision, Controlling And Motivation Health Personnel On Stunting Coverage In Health Center South Nias District Putri Satriani Dachi; Ermi Girsang; Sri Lestari Ramadhani Nasution
Jurnal Scientia Vol. 13 No. 02 (2024): Education and Sosial science, March - May 2024
Publisher : Sean Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58471/scientia.v13i02.2976

Abstract

According to the Indonesian Ministry of Health, there are several factors that cause stunting in children, including mothers not having access to healthy and nutritious food such as high protein foods, which causes their children to also lack nutrition. The incidence of stunting has decreased between 2020 and 2021, the prevalence of stunting globally has decreased from 32.6 percent to 22.2 percent, the number of children affected by stunting has decreased from 198 million to 151 million. The aim of this research is to determine whether there is an influence between the role, supervision, control and motivation of health workers on stunting coverage in the South Nias District Health Center. The type of research used is quantitative analytics. The research design is a cross-sectional study. The sampling technique in this research is the total population, that is, the entire population is used as the research sample, so the total sample in the research is 360 employees. The results of the research explain that there is an influence between the role, supervision, control and motivation of health workers on stunting coverage in the South Nias District Health Center. It is hoped that this research can have a positive impact on the coverage of stunting in the South Nias Regency Health Center.
Analysis of effect strategies in improving water quality diarrhea prevention on Hilibala health center, South Nias district Erisman Hondro; Sri Lestari Ramadhani Nasution; Ermi Girsang
Jurnal EduHealth Vol. 15 No. 01 (2024): Jurnal eduHealt, Edition January - March, 2024
Publisher : Sean Institute

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Abstract

Hilibala Community Health Center is the largest contributor to diarrhea cases, namely 662 cases. One of the causes is poor water quality. Therefore, this study aims to analyze the effect of health promotion in improving water quality to prevent diarrhea. The location of this research was carried out in the working area of the Hilibala Community Health Center, South Nias Regency. The research will start in June-August 2023. The sample in this study was 99 families and was determined using a purposive sampling formula. There were 6 informants for this research. The data was analyzed univariately, bivariately, and multivariately as well as by theme analysis. The results of the research show that there is an influence of advocacy, partnership, and community empowerment on the role of families in improving water quality as an effort to prevent diarrhea at the Hilibala Community Health Center, South Nias Regency, with the results of statistical tests obtaining a significant p-value for each, namely 0.000 < 0.05. The variable that influences this is the empowerment variable with a p-value of 0.000, OR = 9.333 (95% CI = 3.085), while the strategy used to improve water quality as an effort to prevent diarrhea at the Hilibala Health Center, South Nias Regency is to empower the community, such as working together to find clean water locations, digging wells and maintaining the cleanliness and quality of the water. This research concludes that the right strategy is to increase empowerment as a health promotion strategy in improving water quality to prevent diarrhea at the Hilibala Community Health Center, South Nias Regency. Suggestions for community health centers are to carry out situation analysis, outreach, cadre formation and intervention, and evaluation. The results of community empowerment activities with character building have a good impact, namely that the majority of people have increased understanding. The quality of life of the community will also improve as seen from the reduced number of diarrhea incidents.
An Analysis Of Drug Planning Using ABC Index Method Critical In The Pharmacy Installation Public Hospital Royal Prima Marelan Disti Amanda Putri; Ermi Girsang; Sri Lestari Ramadhani Nasution
Jurnal Scientia Vol. 13 No. 04 (2024): Education and Sosial science, September-December 2024
Publisher : Sean Institute

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Abstract

Needs planning is an activity to determine the quantity and period of procurement of pharmaceuticals, medical devices and disposable medical materials in accordance with the results of selection activities to ensure that the criteria for the right type, right quantity, right time and efficiency are met. The purpose of the research is to analysed drug planning with ABC critical index method at the Pharmacy Installation of Royal Prima Marelan Hospital. Type This study is a combination of qualitative and quantitative research at the Pharmacy Installation at Hospital.Royal Prima Marelan. The qualitative sample of the study was 3 people and the data source was the drug needs plan. The research instrument used a questionnaire. The results of this study with ABC analysis of the critical index value of group A usage were 30 items (51%), group B obtained 23 items (39%) and group C obtained 8 items (9%). Based on the calculation with ABC analysis of the critical index of investment value, group B obtained 2 items (3%) of the total items and group C obtained 57 items (97%) of the total items in the Pharmacy Installation. Based on the calculation with ABC analysis of the critical index of investment value, group B obtained 2 items (3%) of the total items and group C obtained 57 items (97%) of the total items in the Pharmacy Installation. The results of qualitative research on drug planning at the Pharmacy Installation of Hospital. Royal Prima Marelan used the consumption method, namely looking at the average use of drugs in the previous 3 months, at the time of service there were still frequent stock outs of drugs. It is necessary to prepare and evaluate a drug requirement plan (RKO) which is carried out every month as a basis for planning drug requirements and/or can use methods to analysed drug requirements that are efficient, effective and appropriate.
An analysis of the role health personnel, health facilities and family support in increasing pregnant women's interest in antenatal care visits at Kuta Alam health centre Winda Tri Mutia; Ermi Girsang; Sri Lestari Ramadhani Nasution
Jurnal Ekonomi Vol. 13 No. 01 (2024): Jurnal Ekonomi, Edition January - March 2024
Publisher : SEAN Institute

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Abstract

Antenatal Care is one of the pillars supporting safe motherhood in efforts to reduce maternal and fetal morbidity and mortality. WHO estimates that 500,000 pregnant women die from pregnancy-related complications. There are factors that can influence Antenatal Care visits, including the role of health workers and family support. This study aims to analyze the role of health workers and family support in increasing pregnant women's interest in antenatal care visits at the Kuta Alam Community Health Center. This type of research is quantitative analysis using a cross sectional design. The population in this study is mothers who have given birth and had babies during the period September 2020-September 2023, totaling 250 respondents. The results obtained were significant (p=0.002) and there was a relationship between Health Facilities and Antenatal Care visits. The results obtained were significant (p=0.001) and the variables that had an influence in increasing pregnant women's interest in ANC visits at the Kuta Alam Community Health Center were the Health Facilities variable with p value 0.001, OR = 9.333 (95% CI = 3.085) meaning that respondents who stated health facilities had 9.333 times the odds compared to respondents who stated health workers were provided with a B coefficient value of 2.413.