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Hospital financial control strategy in the COVID-19 Pandemic era Citra Mutiarahati, Ni Luh; Ani, Luh Seri; Suarjana, Ketut; Januraga, Pande Putu; Manuaba, I.B.G. Fajar; Lesmana, Cokorda Bagus Jaya; Indrayathi, Putu Ayu
Public Health and Preventive Medicine Archive Vol. 11 No. 1 (2023)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2023.v11.i1.p06

Abstract

Background and purpose: The pandemic of COVID-19 is an unprecedented medical and economic challenge for healthcare system. The number of patients during pandemic of COVID-19 had a rapid growth which led to changes in services aspects that threaten financial viability of hospitals, including private hospitals. This study aims to determine the efforts of private hospitals in maintaining financial stability during the pandemic of COVID-19. Methods:  A qualitative study with a multi-case design carried out in 7 (seven) private hospitals in Denpasar. Informants were obtained based on a purposive sampling approach. This study recruited 19 informants from 7 private hospitals in Denpasar. Data was collected through in-depth interviews conducted face-to-face, using the Zoom and Whatsapp applications. The data were analysed using a content analysis approach. Results: Almost all hospitals stated that their finances disrupted. Financial mitigation efforts were difficult to do, hospital preparation and responses were dependent on the hospital's financial condition and regulations that changing, and recovery efforts were not easy either because in general the community's economy has not recovered. Conclusion: Private hospital finances were experiencing disruption. Mitigation efforts were difficult to do due to the unpredictable changing regulations and policies during the pandemic. Based on the study results, it can be recommended that the hospital management needs to develop a service strategy that is able to overcome the problem of the surge in the number of patients.
Determinants of the intention to use National Insurance Mobile Application in Badung District based on Technology Acceptance Model Framework Indrayathi, Putu Ayu; Megayanti, Ni Luh Komang; Ulandari, Luh Putu Sinthya; Kolozsvari, Laszlo Robert
Public Health and Preventive Medicine Archive Vol. 10 No. 2 (2022)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2022.v10.i2.p02

Abstract

Background and purpose: National Insurance Mobile Application (JKN Mobile) developed by Health Insurance Institution (BPJS Kesehatan) to facilitate the administrative activities of the National Health Insurance (JKN) participants. However, in practice, it has yet to be widely used by JKN participants. This study aims to explore factors determine participants' intention to use the JKN Mobile application based on the Technology Acceptance Model (TAM) Framework. Methods: This cross-sectional study was conducted in April-May 2021. The minimum required sample size was 99. Inclusion criteria were people 18 years of age or older, residing in Badung District, Bali Province and at least having used the JKN Mobile once. Data were collected through a self-administered questionnaire. A multivariable analysis was then conducted to determine the factors of intention to use the JKN Mobile application. Results: The proportion of JKN participants interested in using the JKN Mobile was 50%. Perceived usefulness, ease of use, credibility, and amount of information were correlated with the intention to use the JKN Mobile. The linear regression analysis showed that perceived usefulness is significantly associated with the intention to use JKN Mobile (aOR=9.68; 95%CI: 3.33-28.14; p=0.001). Conclusion: Participants' acceptability to use JKN Mobile is associated with the benefits of using such an application. It is thus imperative for BPJS Kesehatan to simultaneously update the design and features to be readily accepted and used by the public, which will later affect interest in using the application.
FAKTOR YANG BERHUBUNGAN DENGAN TINGKAT PENGETAHUAN PEGAWAI PUSKESMAS MENGENAI KESELAMATAN PASIEN DI PUSKESMAS SUKASADA I Indrayathi, Putu Ayu; Krismayani, Tika
ARCHIVE OF COMMUNITY HEALTH Vol 11 No 1 (2024): April 2024
Publisher : Program Studi Sarjana Kesehatan Masyarakat Universitas Udayana Berasosiasi Dengan Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/ACH.2024.v11.i01.p08

Abstract

Keselamatan pasien merupakan suatu sistem yang membuat asuhan pasien menjadi lebih aman. Keselamatan pasien sangat penting di era Jaminan Kesehatan Nasional (JKN) karena menganut sistem managed care yang mengharuskan masyarakat untuk melakukan rujukan berjenjang dari pelayanan kesehatan dasar yaitu puskesmas. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan tingkat pengetahuan pegawai puskesmas mengenai keselamatan pasien di Puskesmas Sukasada I Kabupaten Buleleng. Desain penelitian yang digunakan adalah penelitian kuantitatif deskriptif dengan rancangan cross-sectional study. Sampel dari penelitian ini yaitu seluruh pegawai puskesmas yang bekerja di Puskesmas Sukasada I. Penelitian dilakukan dari bulan April Tahun 2020. Instrumen pengumpulan data menggunakan kuesioner yang terdiri dari pertanyaan tertutup yang akan diisi sendiri oleh responden. Analisis data dilakukan secara univariat dan bivariat dengan uji chi square. Hasil penelitian menunjukkan sebanyak 56,00% responden memiliki tingkat pengetahuan yang baik tentang keselamatan pasien. Terdapat hubungan bermakna antara variabel pendidikan dengan tingkat pengetahuan (p<0,05), sedangkan variabel umur, jenis kelamin, pengalaman kerja dan pelatihan tidak terdapat hubungan bermakna dengan tingkat pengetahuan. Pihak puskesmas lebih aktif dalam melakukan sosialisasi maupun pelatihan mengenai keselamatan pasien di puskesmas. Kata Kunci: Tingkat pengetahuan, Keselamatan pasien, Puskesmas, Pegawai
ANALISIS IMPLEMENTASI DIMENSI BUDAYA KESELAMATAN PASIEN OLEH PETUGAS KESEHATAN DI PUSKESMAS WILAYAH KERJA DINAS KESEHATAN KABUPATEN KARANGASEM Indrayathi, Putu Ayu; Krismayanti, Ni Kadek Ari
ARCHIVE OF COMMUNITY HEALTH Vol 11 No 1 (2024): April 2024
Publisher : Program Studi Sarjana Kesehatan Masyarakat Universitas Udayana Berasosiasi Dengan Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/ACH.2024.v11.i01.p10

Abstract

Keselamatan pasien merupakan suatu sistem yang membuat asuhan pasien lebih aman. Salah satu faktor keberhasilan program keselamatan pasien adalah budaya keselamatan pasien. Penelitian ini bertujuan untuk mengetahui implementasi dimensi budaya keselamatan pasien oleh petugas kesehatan di Puskesmas Wilayah Kerja Dinas Kesehatan Kabupaten Karangasem. Desain penelitian ini adalah deskriptif dengan metode kualitatif. Informan dari penelitian ini merupakan tenaga kesehatan yang ada di Puskesmas Kubu I, Puskesmas Selat dan Dinas Kesehatan Kabupaten Karangasem sejumlah 17 orang yang dipilih melalui teknik purposive sampling. Instrumen pengumpulan data menggunakan pedoman wawancara mendalam. Analisis data yang dilakukan melalui transkrip hasil wawancara, pengkodean, open coding, mencari pola dan hubungan, menarik kesimpulan serta interpretasi data. Hasil penelitian menunjukkan implementasi 12 dimensi budaya keselamatan pasien yang ada di puskesmas terdapat beberapa dimensi yang belum berjalan optimal. Implementasi pada puskesmas dengan kunjungan tertinggi dan terendah tidak memiliki perbedaan secara signifikan. Perbedaan jumlah insiden yang signifikan antar puskesmas terjadi karena kesadaran pencatatan yang rendah. Hambatan dalam program keselamatan pasien yaitu terjadinya over lapping, kurangnya pelatihan dan pedoman terkait keselamatan pasien. Kesimpulan dari penelitian ini adalah implementasi budaya keselamatan pasien di puskesmas belum optimal dan perlu ditingkatkan sehingga diperlukan dukungan dari seluruh aspek baik dinas kesehatan maupun puskesmas agar dapat menciptakan keselamatan pasien di puskesmas. Kata Kunci : Keselamatan Pasien, Petugas Kesehatan, Puskesmas
UPAYA PENCEGAHAN STUNTING DENGAN HIGIENE INDIVIDU DAN KEAMANAN PANGAN DI DESA LEBIH GIANYAR Dwipayanti, N.M.U.; Indrayathi, P.A.; Kurniawati, D.P.Y.; Adhi, K.T.
Buletin Udayana Mengabdi Vol 23 No 4 (2024): Buletin Udayana Mengabdi
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/BUM.2024.v23.i04.p06

Abstract

One of the health priorities in the Sustainable Development Goals is address malnutrition, including stunting among children. Gianyar Regency is one of the districts with the highest prevalence of stunting. Previous studies showed that the incidence of stunting in the locus area was due to lack of hygienic behavior in food handling for infant and the availability of safe drinking water, thus this behaviour need intervention. The intervention targeted mothers of children under five and pregnant women in posyandu (a community based health care). The activity integrates the nutritional emodemo approach and Community-Based Total Sanitation, pillar 2 and pillar 3. This intervention aimed to empower village cadres and the community to take collective action for behavior change and independently maintain the sustainability of these changes. Trained posyandu cadres carry out promotional activities at the posyandu. Posyandu participants in Bajar Kesian, Lebih Duur Kaja and Lebih Beten Kelod were provided with health promotions related to healthy nutrition, personal hygiene and safety of food and household drinking water. This promotional activity is expected to be carried out regularly by posyandu cadres in their respective posyandu, thus it will become a continuous promotion effort in Lebih Village to improve healthy and hygienic parenting. Keywords: cadres, Gianyar, food hygiene, personal hygiene, posyandu, stunting
Strategi Implementasi Jaminan Kesehatan Nasional dengan Metode Balanced Scoredcard: Studi Kasus di Rumah Sakit X Tangerang Tahun 2018 Ulandari, Luh Putu Sinthya; Ilyas, Jaslis; Indrayathi, Putu Ayu
Jurnal Ekonomi Kesehatan Indonesia Vol. 5, No. 2
Publisher : UI Scholars Hub

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Abstract

One of the private hospital successful implementation the National Health Insurance with cost efficiency without neglecting the quality of service is X Hospital. This study aimed to finding out the strategy of X Hospital in the implementation of the National Health Insurance with Balanced Scorecard. The research was conducted in May 2018 using qualitative approach. Data was collected through in-depth interview to 7 informants from hospital and 2 informants from BPJS Kesehatan. The subjects were selected purposively and the data was analyzed using thematic analysis. The results show that there are several strategies that have been developed and implemented, including: (1) financial perspective (adding types of services, increasing the capacity of inpatients and polyclinics, increasing doctor practice slots, completing medical equipment, applying the principle of low cost and increasing working capital); (2) customer perspective (choosing target market, develop 5 values propotition, complaint management); (3) internal business processes perspective (develop standard operating procedures, develop drug formulary and clinical pathways, carry out operational and audit controls, build business models, form case mix teams and claim management);(4) learning and growth perspective (develop training, giving reward and good salaries, build a competitive work environments, and pay attention to employee career paths). Through this strategy, X Hospital is able to implement the JKN Program well and still record a surplus without sacrificing service quality.
Infodemic, Health Promotion Efforts, and Preventive Behavior During the COVID-19 Pandemic in Indonesia: A Quantitative Analysis Study Kurniati, Desak Putu Y; Indrayathi, Putu Ayu; Pradnyani, Putu Erma; Ulandari, Luh Putu S; Januraga, Pande Putu; Yuliarti, Monika Sri; Santosa, Karina Samaria
Kesmas Vol. 18, No. 5
Publisher : UI Scholars Hub

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Abstract

The coronavirus disease 2019 (COVID-19) is the first pandemic in history where technologies and social media are used on a large scale to make people safe, informed, productive, and connected. At the same time, these technologies enabled the rise of the infodemic, which endangered pandemic control. This study aimed to assess COVID-19 information exposure in the community, the efforts to find related information in online media, and COVID-19 preventive behavior. A cross-sectional study was conducted with 909 participants in Indonesia using the consecutive sampling technique. Data were collected using a questionnaire distributed through social media (WhatsApp, Instagram, and Facebook) and analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that about 838 (92.2%) participants said they often or always obtain information about COVID-19 online, 662 (72.8%) participants stated that information from online sources increased their knowledge of the disease, and 728 (80.1%) said that online information enabled them to make preventive efforts. Marital status (AOR: 1.81, p-value = 0.002) and perceived susceptibility (AOR: 1.42, p-value= 0.011) were the most influential factors for COVID-19 preventive behaviors. Information sources and channels frequently accessed by the community must be professionally managed by the government as valuable tools for mitigating an epidemic or pandemic.
Basis for Development of Business Strategic Plan Primary Health Care with Local Public Service Entity Status in Gianyar District Indrayathi, Putu Ayu; Ulandari, Luh Putu Sinthya
Kesmas Vol. 11, No. 2
Publisher : UI Scholars Hub

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Abstract

Puskesmas yang berbentuk Badan Layanan Umum Daerah (BLUD) perlu membuat rencana strategi bisnis yang tepat. Penyusunan rencana strategi bisnis perlu memerhatikan pesaing yang beroperasi di sekitar wilayah kerja. Penelitian ini bertujuan untuk mempelajari aspek lingkungan internal dan eksternal di Puskesmas Ubud 1 dan Tegallalang 1 serta mengembangkan model pengembangan rencana strategi bisnis di kedua puskesmas yang berstatus BLUD tersebut. Penelitian ini merupakan penelitian deskriptif eksploratif yang dilakukan pada tahun 2014. Data dikumpulkan melalui penyebaran kuesioner dan studi dokumentasi. Sampel penelitian ditentukan secara purposif dan diambil secara non proporsional, terdiri dari kepala dan staf Puskesmas Ubud 1 dan Tegallalalng 1. Data dianalisis secara deskriptif kuantitatif. Hasil analisis faktor internal dan eksternal kedua puskesmas menunjukkan hasil yang sama. Sebagian besar indikator variabel internal merupakan kekuatan, hanya kuantitas tenaga kerja bidang medis dan nonmedis sebagai kelemahan dalam pengembangan program. Sedangkan hasil analisis faktor eksternal menunjukkan sebagian besar indikator variabel eksternal merupakan peluang dan hanya perilaku masyarakat terhadap lingkungan yang merupakan ancaman dalam pengembangan program. Sebagai kesimpulan, posisi strategis pengembangan di Puskesmas Ubud 1 dan Tegallalang 1 adalah strategi pertumbuhan. Primary health care as Local Public Service Entity needs to make the right business strategic plan. Arranging business plan needs to pay attention to its competitors operating around its working area. This study aimed to determine internal and external environmental factors in Ubud 1 and Tegallalang 1 Primary Health Care and develop model of business strategic plan development in both primary health cares with Local Public Service Entity status. This study was descriptive explorative conducted in 2014. Data were collected through questionnaires, and documentation study. Samples were determined purposively or taken non-proportionally, consisting of Ubud 1 and Tegallalang 1 Primary Health Care heads and staff. Data were analyzed by descriptive quantitative analysis. Results of internal and external factor analysis in both primary health cares showed similar findings. Most indicators of internal variable were strength, only quantities of medical and non-medical workers were the weaknesses in program development. Meanwhile, external factor analysis showed that most indicators of external variable were opportunities and it was only people’s lifestyle toward environment as the threat in program development. In conclusion, the development strategic position in Ubud 1 Tegallalang 1 was growth strategy.
Mutu Pelayanan Puskesmas Perawatan yang Berstatus Badan Layanan Umum Daerah Indrayathi, Putu Ayu; Listyowati, Rina; Nopiyani, Ni Made Sri; Ulandari, Luh Putu Sinthya
Kesmas Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

Kebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan cara multistage random sampling. Data kualitatif dikumpulkan melalui wawancara mendalam kepada 13 penyedia pelayanan kesehatan yang dipilih secara purposive sampling. Data kuantitatif dianalisis secara deskriptif dan data kualitatif dianalisis dengan analisis tematik. Dari hasil penelitian, pelayanan di puskesmas perawatan berstatus BLUD di Gianyar dinilai kurang memuaskan karena keterbatasan peralatan medis dan kurangnya tenaga yang kompeten dalam pengelolaan keuangan. Pelatihan pengelolaan keuangan pada staf puskesmas dan perekrutan tenaga berlatar belakang akuntansi penting untuk dilakukan. The policy of primary health care as local public service agencies (BLUD) was established to improve the quality of basic health care services. The public service agencies primary health care policy has been implemented to all primary health care in Gianyar district since 2010. The implementation does not always improving health service quality. This research was aimed to overview the quality of services in primary health care with general services agency status in Gianyar district. This research was a crosssectional study with mixed of quantitative and qualitative approaches.This research was conducted in Gianyar between August and December 2013. The quantitative data was collected through questionaire survey to 105 patients in four primary health care who were chosen with multistage random sampling technique. The qualitative data was collected through in-depth interviews to 13 health care providers in primary health care who were chosen with pusposive sampling. The quantitative data was analysed descriptively and the qualitative data was analysed using thematic analysis. The result of the study was primary health care quality in BLUD puskesmas with inpatient services was perceived as poor due to the limited availability of medical equipment and lack of staff who major in financial management. Training on financial management and recruitment of staff with accounting background should be conducted.
Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan Nopiyani, Ni Made Sri; Indrayathi, Putu Ayu; Listyowati, Rina; Suarjana, I Ketut; Januraga, Pande Putu
Kesmas Vol. 9, No. 4
Publisher : UI Scholars Hub

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Abstract

Pekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun sebagian PSP memiliki kemauan untuk menjadi peserta JKN dan memiliki kemampuan membayar iuran JKN. Faktor penghambat akses JKN pada PSP adalah rendahnya pengetahuan mengenai prosedur pendaftaran dan portabilitas JKN, kekhawatiran keberlanjutan pembayaran iuran, persepsi buruk mengenai kualitas layanan yang akan diterima jika menggunakan JKN, ketidaklengkapan administrasi kependudukan serta kebijakan yang mengharuskan peserta bukan penerima bantuan iuran (Non-PBI) Mandiri untuk mendaftarkan seluruh anggota keluarga. Akses JKN pada PSP terhambat oleh faktor-faktor individual, layanan dan kebijakan yang perlu diatasi untuk meningkatkan cakupan JKN pada PSP. Female sex workers (FSW) is marginalized social group having a high vulnerability of health problems. Effort to expand national health insurance on FSW is still limited, so it is necessarily performed in order to support the achievement of universal health coverage. This study aimed to obtain the depiction of the insurance access among FSW in Denpasar. This study was qualitative. Data was collected through in-depth interview of 15 FSW and four pimps in Denpasar from August to October 2014. The interview result was analyzed using thematic analysis. The analysis framework used was The Health Access Livelihood Framework. The insurance ownership among FSW in Denpasar was low, even though some FSW were willing to be participants and afford to pay the premium. Factors inhibiting the insurance access were the lack of knowledge regarding registration procedures and portability, fear of premium payment sustainability, negative perceptions of quality of services that would be received if using the insurance, incomplete population administration and policy requiring independent non-premium support receiver participants to register all of their family members. The insurance access among FSW was hindered by individual, service and policy factors that need to be conquered to increase the insurance coverage among FSW.
Co-Authors Adhi, K.T. Anak Agung Sagung Istri Maradi Suryaningrat Anastasia Septya Titisari Benny Tjahjono Budiastri Citra Mutiarahati, Ni Luh Cokorda Bagus Jaya Lesmana, Cokorda Bagus Jaya Coratry Shovariah Premilga Desak Putu Yulita Kurniati Dinar Lubis Dinar Lubis Dyah Pradnyaparmita Duarsa Fery Dwiyanto HARI MULYAWAN Hendrayani, Ni Wayan Ani I Gusti Ayu Agung Putri Krismayanthi I Ketut Suwiyoga I Ketut Tunas I Made Ady Wirawan I Made Artana I Nyoman Gede Budiana I Putu Ganda Wijaya I Putu Ganda Wijaya I Putu Ganda Wijaya Ilyas, Jaslis Istiana Marfianti Istiana Marfianti Ketut Suarjana Kolozsvari, Laszlo Robert Krismayani, Tika Krismayanti, Ni Kadek Ari Kurniati, Desak Putu Y Kurniawati, D.P.Y. Laszlo Robert Koloszvari Laszlo Robert Kolozsvari Luh Kadek Ratih Swandewi Luh Kadek Ratih Swandewi Luh Putu Sinthya Ulandari Luh Seri Ani Made Nopy Diah Sundari Manuaba, I.B.G. Fajar Megayanti, Ni Luh Komang Monika Sri Yuliarti Monika Sri Yuliarti, Monika Sri Murniati, Ni Nengah N.M.U. Dwipayanti Ngakan Putu Anom Harjana Ni Ketut Sutiari Ni Luh Saptiaryati Ni Made Ari Listiani Ni Made Mas Dwi Purwaningrat Ni Made Sri Nopiyani Ni Nengah Murniati Ni Nyoman Intan Widya Sari Ni Wayan Ani Hendrayani Ni Wayan Arya Utami, Ni Wayan Arya Nijyoti, Nitya Nirmala, Putu Nitya Nitya Nijyoti Pande Made Sri Rahayu Pande Putu Januraga Putu Dwiki Damadita Putu Erma Pradnyani Putu Inok Puspaeni Putu Nitya Nirmala Putu Novi Trisna Dewi R. A.T. Kuswardhani Rasmaya Niruri Rasmaya Niruri Rasmaya Niruri Rina Listryowati Rina Listyowati Rina Listyowati Rina Listyowati, Rina Rini Noviyani Sagun Chandra Yowani Santosa, Karina Samaria Sri Idayani Sri Idayani, Sri Suandana, Iwan Abdi Sundari, Made Nopy Diah Ulandari, Luh Putu S WIDARSA WIDARSA Wijaya, I Putu Ganda Yaslis Ilyas