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All Journal Jurnal Kedokteran Brawijaya JAM : Jurnal Aplikasi Manajemen Journal of Community Health and Preventive Medicine (JOCHAPM) Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Aryo Dewanto
Fakultas Kedokteran Universitas Brawijaya
Decision Sciences, Operations Research & Management Environmental Science Health Professions Medicine & Pharmacology Nursing Public Health

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Pengembangan Instrumen Penilaian Kualitas Layanan Rumah Sakit Kartikasari, Dwi; Dewanto, Aryo; Saleh, Maya Syahria
Jurnal Kedokteran Brawijaya Vol 28, No 1 (2014)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2014.028.01.14

Abstract

Pengukuran kualitas pelayanan secara berkala merupakan titik masuk dalam peningkatan mutu berkelanjutan. Penelitian ini bertujuan untuk mengembangkan instrumen penilaian kualitas layanan. Instrumen dikembangkan berdasarkan kuesioner kualitas layanan yang disusun oleh Padma yang selanjutnya dianalisis untuk melihat faktor pembentuk dimensi kualitas layanan. Data dikumpulkan menggunakan kuesioner delapan dimensi kualitas layanan yang diukur berdasarkan persepsi pasien menggunakan skala Likert 5 poin. Kuesioner diberikan pada 84 pasien di Instalasi Rawat Jalan, Instalasi Rawat Inap dan Instalasi Gawat Darurat (IGD). Analisis data menggunakan Confirmatory Analysis Factor (CFA ) dengan uji kecukupan sampel KMO MSA>0,50 pada semua dimensi dengan signifikasi bartlett test 0,00 (Sign<0,05). Ekstraksi dan rotasi faktor dilakukan hingga terbentuk satu komponen pada satu dimensi. Hasil penelitian ini menunjukkan bahwa dari 8 dimensi kualitas layanan yang terdiri 59 item pernyataaan, setelah dilakukan analisis menggunakan Confirmatory Factor Analysis (CFA) dengan loading factor diatas 0,50, menghasilkan 3-7 item pada masing-masing dimensi sehingga didapatkan 37 item. Dimensi infrastruktur dibentuk oleh 5 item, kualitas personil dibentuk oleh 6 item, proses perawatan klinis dibentuk oleh 4 item, prosedur administrasi dibentuk oleh 4 item, indikator keselamatan pasien dibentuk oleh 3 item, citra rumah sakit dibentuk oleh 5 item, tanggung jawab sosial dibentuk oleh 3 item, dan kepercayaan terhadap rumah sakit dibentuk oleh 7 item.Kata Kunci: Kepuasan pasien, kualitas layanan rumah sakit, kuesioner
Faktor Penghambat Pelaksanaan SPO 7 Benar dalam Pemberian Obat di Ruang Rawat Inap Rumah Sakit Panti Nirmala Sthephani, Pratiwi; Dewanto, Aryo; I, Cecilia Widijati
Jurnal Kedokteran Brawijaya Vol 28, No 2 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (695.47 KB) | DOI: 10.21776/ub.jkb.2015.028.02.19

Abstract

Laporan keselamatan pasien RS Panti Nirmala terdapat 34,1% kejadian yang berhubungan terhadap kesalahan pemberian obat. Hal ini mengindikasikan pelaksanaan pemberian obat berdasarkan 7 benar belum berjalan dengan baik. Tujuan dari penelitian ini adalah untuk mengidentifikasi, menganalisis faktor penghambat pelaksanaan pemberian obat berdasarkan 7 benar sesuai standar prosedur operasional (SPO)di ruang rawat inap RS Panti Nirmala. Penelitian ini dilakukan dengan metode observasi terhadap 39 perawat pelaksana di 7 unit ruang rawat inap pada shift pagi dan sore waktu pemberian obat, baik obat oral dan intravena. Setelah melakukan observasi, peneliti memberikan kuesioner untuk mengukur pengetahuan, sikap dan kemauan perawat. Kuesioner dibagikan kepada 49 orang perawat pelaksana ruang rawat inap. Hasil observasi menunjukkan 64,9% perawat melakukan benar pasien, 86,5% perawat melakukan benar obat, 64,9% perawat melakukan benar waktu, dan 100% perawat melakukan benar dosis, benar cara dan dokumentasi. Hasil kuesioner menunjukkan terdapat 89% perawat rawat inap RSPN memiliki pengetahuan yang baik tentang prinsip 7 benar. Perawat juga memiliki sikap yang baik dalam pelaksanaan pemberian obat berdasarkan tujuh benar dan mau menjalankan prinsip tujuh benar dalam pemberian obat. Hal tersebut disebabkan kurangnya komunikasi yang efektif pada perawat terhadap pasien maupun keluarga. Kata Kunci: 7 benar, pemberian obat, perawat
Penyampaian Informasi oleh Perawat dalam Persetujuan Tindakan Medis di Rumah Sakit: Permasalahan dan Solusi Satiti, Yudha Rose; Susilo, Harsono; Dewanto, Aryo
Jurnal Kedokteran Brawijaya Vol 28, No 2 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2015.028.02.10

Abstract

Tuntutan hukum di bidang kesehatan menjadi perhatian utama rumah sakit di Indonesia karena menghabiskan waktu, biaya dan mencemarkan citra rumah sakit. Banyak kasus dugaan malpraktik terjadi karena kurang baiknya penyampaian informasi yang berisiko terhadap tuntutan hukum dan mutu rumah sakit. Penelitian dilakukan dengan cara observasi di ruang rawat inap dan UGD, untuk mengamati proses penyampaian  tiap tindakan medis yang dilakukan oleh perawat. Observasi dilakukan berdasarkan PERMENKES Nomor 290/MENKES/PER/III/2008 tentang Persetujuan Tindakan Medis. Untuk mencari akar dari penyebab masalah dilakukan brainstorming dengan peserta 6 orang terdiri dari kepala perawat dan tim mutu dilanjutkan dengan pembuatan fishbone dan teknik “5 Whys” untuk mencari akar masalah. Dari hasil penelitian didapatkan hanya 50% tindakan yang ada formulir tindakan dilakukan persetujuan informasi medis sebelum tindakan dan 100% tindakan yang tidak ada formulir, semua persetujuan informasi medis dilakukan sebelum tindakan. Penjelasan tindakan masih sangat rendah berkisar antara 0-30%. Dari hasil brainstorming didapatkan akar permasalahan adalah pemahaman cara menjelaskan informasi medis rendah, belum ada SK pendelegasian pada perawat untuk menyampaikan informasi medis, sistem pengawasan belum berjalan, SOP kurang jelas atau kurang spesifik, belum ada alat bantu untuk menjelaskan dan perawat tidak tahu cara komunikasi atau penyampaian yang benar. Hasil penentuan alternatif solusi dengan metode McNamara menemukan bahwa alternatif solusi terbaik adalah pembuatan leaflet terkait penjelasan informasi medis dan flyer untuk edukasi pasien.Kata Kunci: Flyer edukasi, Informasi medis, persetujuan tindakan medis
Factors Affecting Patient's Length of Stay In The Era Of Covid-19 Pandemic In Emergency Room Persada Hospital Simanungkalit, Sylvia Kitty; Holipah, Holipah; Dewanto, Aryo; David, David
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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

Abstract

Length of stay (LOS) of a patient in an Emergency Room (ER) is the interval between the time the patient arrives and the time the patient physically leaves the ER. Prolonged LOS has potential to cause crowding. Meanwhile, from a clinical point of view, the factor of LOS has an impact on service suspension, which can reduce patient safety, even to death. Covid-19 pandemic has made hospitals establish a strict patient screening system and has the potential to increase the LOS of patients in the ER. The purpose of this study was to identify the factors that contribute to the LOS of patients. This study is an observational study of 38 respondents who came to the Emergency. LOS was compared between before and during Covid-19 pandemic condition. Observations were carried out by the Time Motion Study method to determine the patient's average time at each stage of the ER. The results showed the average LOS for emergency room patients with inpatient plans was 2 hours 7 minutes, while the LOS during pandemic was 4 hours 46 minutes 52 seconds. There were 2 hours 39 minutes 52 seconds time extension. The time extension is due to several factors: results of laboratory tests SARS COV-2; approval process for the Covid-19 Screening Team; Emergency Room and Laboratory were located in separate buildings.
The Implementation of the Seven-Rights Procedure in Drug administration in a Hospital Inpatient Room: the Inhibiting Factors and Alternative Solutions Puspitasari, Shinta Dwi; Dewanto, Aryo; Holipah, Holipah Holipah; Muliawan, Arrasyid Indra
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Medication error becomes one of the main concerns in ensuring patient safety worldwide. In the first semester of 2020, Hospital X reported two incidents of medication error. Although the incidents were categorised as “adverse event” and “near miss”, it should have been prevented. One of the methods to prevent medication error is the application of the seven-rights procedures in drug administration. This study aims to identify the inhibiting factors in the implementation of the seven-rights procedure in X Hospital as well as to obtain alternative solutions to those inhibiting factors. This study used a cross-sectional design. The data was gathered from 20 nurses at Hospital X using a questionnaire to measure the knowledge, attitude, and behaviour of nurses on the seven-rights procedure. The data is also supported by observation on the actual implementation of the procedures. At the end of the data gathering process, interviews with nurses in inpatient room were conducted to obtain their opinion about the obstacles in applying the seven-rights procedures. The results show that the main problem of drug administration errors was the lack of standard operating procedures (SOP) and nurses’ non-compliance behaviour on the seven-rights procedure. This study also reveals that there is no relationship between the nurses’ knowledge and their behaviour in applying the seven-rights procedures. To prevent medication error, the hospital manager should revise the SOP, conduct a periodic internal refreshment-workshop about the procedure, and perform scheduled supervision to the nurses.
How Do Hospital Staffs Cope with Covid-19 at Work? A Phenomenological Study Febrianto, Wahyu; Indriani, Wiwin; Dewanto, Aryo; -, Holipah
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

The first confirmed Corona Virus Disease 2019 (Covid-19) case in Indonesia was found in March 2020 and rapidly spread out across all provinces. Covid-19 hit unexpectedly that almost all hospitals around the world were unprepared for it. Several studies show that Covid-19 impacts negatively on hospital finance, the mental health of healthcare workers (HCWs), and the death of HCWs. Hasta Brata Hospital (HBH) is one of the hospitals in East Java affected by the pandemic. Therefore, this study aims to investigate the experience of HBH staff face the issues. This study was qualitative research with a phenomenological approach. The data were collected using in-depth interviews with two HBH’s staff. ACovid-19 pandemic causes problems to the hospital, especially the staff. They experienced deep emotional and physical pressure at work, such as fear of infection, repeated conflict with patient's visitor, having different mindsets among staff, and increasing workload. The situation in the community is also frustrating them as the Covid-19 cases keep rising, while people tend to disobey the Covid-19 prevention protocols. Fortunately, they have proper job resource, started from physical support such as the provision of personal protective equipment, nutritional enhancement, and periodic Covid-19 screening; cognitive support such as knowledge update about Covid-19 and its handling methods; to psychological support such as motivational and spiritual support from the HBH leader. Moreover, they also pose strong personal resources that help them to cope with stressful working situations. They could, then, bounce back, feel optimistic that they could fight against Covid-19, with the hope that the pandemic will have an end. Continuous spiritual support gives them another personal resource of tawakkal, an Islamic concept of giving entire resignation and reliance on God only after exerting maximum effort. It seems that job resources and personal resources have succeeded in reducing the highly demanding situation and transform it into positive outcomes. Given a challenging situation, the hospital staffs strive to perform well and bring themselves into their work when providing patient care. Covid-19 pandemic forced the hospital and staff to adapt to the condition quickly. The presence of job resources and the provision of strong personal resources have succeeded in moderating job demands and resulting in positive outcomes. Tawakkal becomes an adding point on staff's personal resources that made them realize that Covid-19 is inevitable, and they have to fight back before finally giving their full resignation to God.
Factors Contributing to Length of Stay Prolongation among Emergency Room Patients during the Covid-19 Pandemic: A Study at Persada Hospital Simanungkalit, Sylvia Kitty; Holipah, Holipah; Dewanto, Aryo; David, David
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.4s

Abstract

Extended length of stay (LOS) in the Emergency Department (ED) results in crowding, potentially causing adverse events and patient dissatisfaction. The Covid-19 pandemic has forced hospitals to implement screening procedures that can extend the LOS of patients in the ED. This study aimed to provide an overview of changes in ED LOS during the pandemic and its contributing factors. This study used a descriptive approach through observation and interviews. LOS observations were conducted using the time & motion study method to determine the average time in each ED stage. The observation results identified the differences in the average LOS during the Covid-19 pandemic, which was 2 hours 39 minutes 52 seconds, and the longest time was on laboratory examination (2 hours 59 minutes 27 seconds). A lengthy laboratory examination duration is due to the additional laboratory examination procedure (serology) for SARS COV-2, suboptimal screening team, and the absence of notification in the hospital information system.
Seven Rights of Medication Administration: Nurses' Knowledge, Attitude, and Compliance Puspitasari, Shinta Dwi; Dewanto, Aryo; Holipah, Holipah; Muliawan, Arrasyid Indra
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.9s

Abstract

Medication error becomes one of the main concerns in ensuring patient safety. In 2020, X Hospital reported medication error incidents. Although categorized near miss, the incidents should have been prevented. One of the methods to prevent medication errors is by applying the seven rights of medication administration. This study aimed to identify the inhibiting factors in the implementation of the seven rights of medication administration in X Hospital and obtain alternative solutions to those obstacles. This study used an analytic observational design with a cross-sectional design. Data were collected from observations and a survey. Observations and a survey through questionnaires to 20 nurses at X Hospital were made to see the implementation of the procedure. At the end of the data collection, interviews were conducted to find out the obstacles in the inpatient installation in applying the seven rights of medication administration. The results show that the main root causes of medication administration errors were the standard operating procedure (SOP) that has not been standardized and nurses' non-compliance behavior on the seven rights procedure. To resolve medication administration errors, the hospital manager should revise the SOP, conduct internal workshops, and perform scheduled supervision to the nurses.
How Do Hospital Staff Cope with Covid-19 at Work? A Phenomenological Study Febrianto, Wahyu; Indriani, Wiwin; Dewanto, Aryo; Holipah, Holipah
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.6s

Abstract

The Covid-19 pandemic has brought negative consequences on hospital finances, the mental health of health care workers (HCWs), and even resulted in the deaths of several health workers at Hasta Brata Hospital (HBH). This study aimed to explore the experiences of HBH's staff in dealing with the pandemic in the hospital. This research is qualitative research with a phenomenological approach. Data were collected using in-depth interviews with two of HBH's staff and then followed by the theme analysis. Hospital staff experienced job demands including emotional and physical stress at work, fear of infection, repeated conflicts with patient visitors, different mindsets among staff, increased workload, and feelings of frustration towards people who do not comply with prevention protocols. Fortunately, they had adequate job resources, ranging from the provision of personal protective equipment, nutrition improvement, and regular Covid-19 screening; update knowledge and methods of handling Covid-19; to motivational and spiritual support from HBH leaders. The staff also had strong personal resources so that they could cope with stressful work situations, feel optimistic that they could win against Covid-19, and hoped that the pandemic would end. Spiritual support embodies tawakal, an Islamic concept that gives complete surrender to God after employing maximum effort. The presence of strong job and personal resources has moderated job demands and resulted in work engagement. Tawakal is an added value for personal resources staff who finally realize that Covid-19 cannot be avoided and must be fought before surrendering entirely to God.
Pengaruh Employee Engagement terhadap Kepuasan Kerja dan Turnover Intention Perawat (Studi pada Rumah Sakit Wava Husada Kepanjen Malang) Rachman, Lutfi; Dewanto, Aryo
Jurnal Aplikasi Manajemen Vol. 14 No. 2 (2016)
Publisher : Universitas Brawijaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (176.848 KB) | DOI: 10.18202/jam23026332.14.2.14

Abstract

Abstract: Human resources is essential to prevent turnover intention of hospital nurses. Nurses engagement is expected to produce nurses satisfaction and finally lower turnover intention. This study aims to examine the effect of employee engagement on job satisfaction and turnover intention of nurses at Wava Husada Hospital Kepanjen-Malang. The research was a cross sectional research. Sample of the study were 102 nurses who work at inpatient and outpatient unit of Wava Husada Hospital. Questionnaire with 5 point Likert scale was used to measure employee engagement, job satisfaction, turnover intention. Path analysis was used to test the direct and indirect direct effect of the variables. The results showed that employee engagement has direct effect on job satisfaction and turnover intention. On the other hand, job satisfaction has direct effect on turnover intention of nurses in hospitals Wava Husada Kepanjen. The results also indicate that there was an indirect effect of employee engagement on turnover intention through job satisfaction
Co-Authors -, Holipah . David . Herjunianto . Herjunianto Asih Tri Rachmi N Cecilia Widijati I, Cecilia Widijati David David David, . Devi, Silvia Shinta Dolly Irbantoro Dolly Irbantoro, Dolly Dwi Kartikasari Endah Woro Utami Fatchur Rochman Fatchur Rochman Fatchur Rochman Fatmawati, Dwi Indah Febrianto, Wahyu Gunawan, Sri Rahmah Hardjanti, Indra Wahju Harsono Susilo, Harsono Hinting, Lia Natalia Holipah, Holipah Holipah, Holipah Holipah Indra Wahju Hardjanti Indriani, Wiwin Kristianingsih, Rey Laksono Trisnantoro Lukman Hakim Lukman Hakim Maemunah Mahardika, Yesika Yuristi Maya Syahria Saleh Megawati, Devvy Muhammad Muchlis Muhammad Muchlis Muliawan, Arrasyid Indra N, Asih Tri Rachmi Noermijati, Noermijati Pratiwi Sthephani, Pratiwi Prayoga, I Wayan Eka Putra Puspitasari, Shinta Dwi Puspitasari, Vicky Rachman, Lutfi Restantin, Riris Linda Sadewo, Ageng Bagus Setijowatie, Eva Diah Silvia Shinta Devi Simanungkalit, Sylvia Kitty Tita Hariyanti Yudha Rose Satiti, Yudha Rose Yunita, Eva